Part 1: Healthcare Data Sources
17
Pharmacy Claims Data
Claims Data Analytics
1
Claims Data Analytics
Getting Started
2
Tuva Fundamentals
3
Data Engineering Tools
4
Data Science Tools
Part 1: Healthcare Data Sources
5
Eligibility and Enrollment Data
6
Medical Claims Data
7
Intro to Claims
8
Headers and Lines
9
Claims Data Elements
10
Claim Types & Codes Tying to Payment
11
Date Fields
12
Common Sources of Claims Data
13
Financial Fields
14
Providers
15
Adjustments, Denials, and Reversals
16
Claims Lag Issues
17
Pharmacy Claims Data
18
Provider Data
19
EHR Data
20
FHIR APIs
21
ADT Messages
22
Lab Results
23
Code Sets
Part 2: Claims Groupers & Algorithms
24
Member Months
25
Member Attribution
26
Service Categories
27
Encounters
28
Conditions & Procedures
Part 3: Analytics
29
Cost Metrics (PMPM)
30
Utilization Metrics (PKPY)
31
ED Visits
32
Acute Inpatient Stays
33
Readmissions
34
Quality Measures
35
HCCs & Risk Adjustment
Claims Data Analytics
Docs
Knowledge
Community
Newsletter
Part 1: Healthcare Data Sources
17
Pharmacy Claims Data
17
Pharmacy Claims Data
Data Generation Process
Claims Forms & Key Data Elements
Adjustments, Denials, & Reversals
Incurred vs. Paid dates & runout
NDC Codes (Talk to Joey)
Prescribing vs. Fill Info
Formulary Nuances
16
Claims Lag Issues
18
Provider Data
