Employer Reporting. User Guide

Transcription

1 Employer Reporting This user guide provides an overview of features supported by the Employer Reporting application and instructions for viewing, customizing, and exporting reports.

2 System Requirements This system is best viewed using Microsoft Internet Explorer 6.0 and Firefox 2+ at a screen resolution of 1024 x 768 or higher. It requires Adobe Flash Player version or higher. Introduction We re pleased to introduce the latest version of our Employer Reporting system. We have made significant improvements to report customization and export features. Future versions will incorporate tool tips that will make it even easier to navigate through the system and master all of the features. In the coming months, all experience reporting will be migrated to the new platform. New features and additional data will give you the information you need to make sound decisions about benefit utilization and costs. This user guide for version 2.0 of the system covers these topics: Accessing Employer Reporting... 3 System Comparison... 4 Key Improvements... 4 Report Cross-Reference... 4 Reporting Improvements... 5 Employer Reporting Basics... 6 Home Page... 6 Reporting Building Blocks... 7 Customize Reporting in Real Time... 8 Adjust Existing Reporting... 9 Customize Workbook... 9 Modify Panels Assemble New Workbook Build New Workbook from Scratch Saving & Sharing Custom Reports Deleting Custom Reports Exporting Reports Workbooks & Worksheets Panels Archiving Reports Viewing Masked Data The Future of Employer Reporting Appendix A Detailed Feature Comparison Appendix B Detailed Report Comparison /16/2009

3 Accessing Employer Reporting Employer reports are visible to three main audiences. Each one uses a different web portal to access them: Audience Employers Agents and Brokers Internal Staff Portal Employer Center Agent Center CRM Each of these portals has a link to reporting. After you select that link you will reach the Highlights report from the previous reporting system. Click the Try EMPLOYER REPORTING link to access the new reporting system. 1. Select Try Employer Reporting to access the new Employer Reporting system. The new system will open in a separate pop-up window. 9/16/2009 3

4 System Comparison This section of the user guide identifies differences between the old and new reporting systems. Key Improvements The new Employer Reporting system supports: Improved standard reporting Real-time customization of reporting, including self-serve ad hoc reporting capabilities. Optional sharing of custom reporting Streamlined exporting of multiple report views Report Cross-Reference Employer Reporting - Standard Claim Lag Cost Containment Enrollment Reporting Dashboard Experience Reporting* High Claimant Reporting N/A Paid Claims Summary Place of Service Summary Specialized Services Summary Stratified Claims Top Medications Top Provider EBR Claim Lag Cost Containment Enrollment N/A Experience Report High Claimant Highlights Paid Claims Statistics Claim Place of Service Summary Specialized Services Analysis Summary Stratified Claims * Embedded in Experience Report Top Provider Summary * Note: Because the new Employer Reporting system refreshes in real time, separate detailed reports for each coverage are not produced. The detailed Experience Reporting defaults to Medical coverage. 4 9/16/2009

5 Reporting Improvements Experience Summary shows monthly breakout by default. Experience Detail has more metrics and benchmark comparisons. Experience Detail defaults to Medical Coverage, switch to Pharmacy, Vision or Dental coverage in real time. Cost Containment reporting has multiple breakouts by coverage, provider agreement, product type & network status. Enrollment reporting now shows contract and member counts. System now supports three age-band structures, which provide more detailed breakouts. High Claimant reporting is unmasked for selected users. High Claimant reporting defaults to Medical & Pharmacy coverage. It defaults to a $25,000 threshold. Stratified Claims reporting has more breakouts and shows members with $0 in claims. Top Provider reporting has more detail on BlueCard providers. Top Medications reporting easier to find. 9/16/2009 5

6 Employer Reporting Basics Home Page This is the screen you ll see after opening the Employer Reporting system: Home Page Navigation Accordion The Home page provides information to help you use the reporting system. It describes the system s icons and contains links to several help resources, including this. The Navigation Accordion organizes reports and contains four sections: Standard Reports: Contains pre-defined reports designed to be useful right away. You can customize and save copies of these to your My Reports section. My Reports: Contains any report that you customize and save. Archived Reports: Contains reports that have been saved with a snapshot of data that existed at a point in time. Provides a repository of historical reports. Shared Reports: Contains all reports that you or other users have decided to divulge to others. 6 9/16/2009

7 Reporting Building Blocks This screen points out the three main components that organize data into reporting: Workbook Worksheet Panel Reporting is organized into workbooks and worksheets, similar to Microsoft Excel. Workbook - Report containers that support global customization and exporting. Workbooks contain one or more worksheets and panels. Worksheet - Worksheets organize panels into logical groupings. Panel The primary report building block. Panels display data in a variety of formats, such as tables and charts. 9/16/2009 7

8 Customize Reporting in Real Time One of the biggest improvements to employer reporting is related to report customization: System customizes reports in real time, instead of overnight. You can control which data elements display on your reports, adding and removing data as appropriate. You can control report formatting, switching between a pivot table and several chart formats. Although powerful, the new system supports a wide range of users, from people just learning to use experience reporting, to expert analysts who are used to evaluating health care data. There are three ways to customize reporting: 1. Adjust standard or shared reporting. 2. Assemble a new workbook from pre-built reporting. 3. Build a new workbook from scratch. Using the first two options to modify existing reports is a simple and powerful way to tailor reporting without having to start to start from scratch. Important Note: Choosing Save and Save As when customizing reporting saves the report format without data. When you choose Save or Save As from the workbook menu, you are creating a template that refreshes each month with new data. This function is different than Save Results, which saves a snapshot of the data along with the report format, or template. See the Archiving Reports section for more information. 8 9/16/2009

9 Adjust Existing Reporting Follow these steps to customize existing reporting to meet your needs. Remember you can modify standard reports, reports you previously customized or reports other people created and shared. Customize Workbook Workbook customization allows you to make global changes to all of the worksheets and panels a workbook contains. Access the workbook customization panel by clicking the edit button selecting Apply Filters or by clicking on the dates that display in the workbook header. and Here is an overall view of the workbook customization panel: 9/16/2009 9

10 Adjust the reporting period by changing Date Range Filters. 1. Data View - Determines if the reporting period is based on paid dates or incurred dates. Selecting Paid allows customization of paid dates only. Selecting Incurred allows both paid and incurred dates to be specified. 2. Current Period Date Options - Used to specify the window for the current report period. Time periods are based on latest paid or incurred month: Default: renewal to date Rolling Year: preceding 12 months Rolling Quarter: preceding 3 months Year to Date: Jan to date Quarter to Date: Jan, Mar, Jul or Oct to date Custom: user specifies dates 3. Prior Period Date Options - Used to specify the window for the prior report period, when shorter than 12 months: Immediate: same number of months, immediately preceding current period Parallel: same months from prior year None: no data will display in prior period Custom: user specifies dates Standard BlueCard Fees - Determines if BlueCard access fees are included or excluded from the claim paid amount. Default is included. 10 9/16/2009

11 Adjust data included in the your workbook with the Apply Filters control. Use this setting to create different workbooks that report on specific coverage, benefit options or components of your company. Note that any filters applied in workbook customization will override similar selections and filters in all of the workbook s panels. Here are descriptions of common filtering options: Employer Section - A division of an employer. Since employers are structured differently, sections vary (e.g., location, function, etc.). Employee Category - A set of employees within a company with similar status (e.g., active/retiree) or benefit selections. Since employers are structured differently, categories may vary sharply. Class Plan/Benefit Package - A package of benefits. Benefit Type - Classifies benefits as HMO, PPO, POS or Traditional. Product Type - A more granular classification of products than Benefit Type. Identifies basic structure on which benefits are built. Use the properties panel to modify the workbook name and description, and modify worksheet names. Keywords and Notes will not display in online or exported reporting. Check Run Reports Monthly to specify that a snapshot of your report is automatically archived monthly. See the Archiving Reports section for more information about this option. Apply your workbook settings by closing the customization panel. 9/16/

12 Modify Panels Panels contain report data. One or more panels exist on each worksheet. Resize panels by clicking on the arrows that appear in the lower right corner. Rearrange panels on a worksheet by grabbing the header and dragging and dropping it. Other panels will automatically arrange themselves around the new position. Remove panels from worksheets by clicking on the Delete button in the upper right corner. Access the panel customization window to modify the data it displays by clicking the edit button in the upper left corner. Panel customization is split into three sections to make it simple to add or remove data, filter the results, and format the appearance. 1. Select Data: In this section, data can be added or removed from the panel. Even when a panel is displayed as a chart, the data reside on either the column or row axis of an underlying data table. Click the add icon next to the column or row heading. Choose the folder (known as a dimension) where the data element is stored. Please see the glossary for additional information. Select the measure or descriptor you want to add/remove from the panel and click Done. The panel will update immediately. Rearrange data elements and move them from one axis to another by dragging and dropping them to new locations in the tree list. 12 9/16/2009

13 2. Apply Filters: In this section, data results in the table can be filtered all the way down to specific values, if desired. Filter Entire Table: Allows you to filter the panel using data elements that were not selected in section 1 and are not visible in the panel. Filter Selections: Allows you to filter the panel using data elements that were selected in section 1 and are visible in the panel. The filtering functionality has been built in such a way, that if a user tries to filter on certain data elements that would not make sense or could create a situation for a security violation, the application will not return data. Instead, you will see the following message in your filter panel: Examples of dimensions that may display the above message while filtering include: Diagnosis Three Digit ICD-9 Employee Category & Category Type Employer Section Incurred Month Incurred Year-Month MCA Participation MCA Transaction Category & Type Medication Network Status Provider - Provider City, State, Zip & Specialty Product Type Benefit & Product Type Provider Agreement Type 9/16/

14 Qualified Wellness Activity Reporting Period Year, Year-Month, Year-Quarter Service Category & Service Category Type 3. Format Display: Allows you to change the panel display between a table and several charting options. Please note that the data in your panel may not be effectively displayed by all chart types. 14 9/16/2009

15 Assemble New Workbook You can assemble a new workbook using components from other existing reporting, be it standard, shared or personal. 1. Create a new workbook by clicking on the workbook document icon and selecting New Workbook. You can also click the add workbook icon in the upper right corner of the workspace. 2. Open a workbook that has worksheets or panels you want to use. Great 3. Click the workbook edit button, select copy from the workbook menu and choose Worksheet or Panel. 4. Identify the worksheet or panel you want to copy into your new workbook in the Duplicate dialog box. 5. Save your changes. 9/16/

16 Build New Workbook from Scratch 1. Create a new workbook by clicking on the workbook document icon and selecting New Workbook. You can also click the add workbook icon in the upper right corner of the workspace. 2. Select New Panel from the workbook document menu. 3. Enter the panel title and description. 4. Click the panel customize icon. 1. Select Data: Choose the data you want to view on your report panel. 2. Apply Filters: Specify constraints that allow you to focus your analysis. 3. Format Display: Choose how you want to present the data as a table or chart. See Modify Panels section of this user guide for additional details. 5. Save your changes. 16 9/16/2009

17 Saving & Sharing Custom Reports By default, custom reports are private. But, users may share their custom reporting. Sharing a workbook makes it available in the Shared Reports accordion for all users authorized to view reporting for the employer. Share while saving workbook. 1. Select Save As from workbook menu. 2. Choose Shared. 3. Click Ok to save. Change the status of existing workbooks by choosing Share and Unshare from the workbook menu. The change takes effect immediately. Deleting Custom Reports You may delete custom reports that you own, once you determine that they are no longer useful. 1. Open the workbook you want to delete. 2. Click the workbook edit button, choose Delete and acknowledge the warning message. 3. Create a new workbook by clicking on the workbook document icon and selecting New Workbook. 9/16/

18 Exporting Reports Employer Reporting currently supports exporting of workbooks, worksheets and panels. You may export reporting into Excel format. Workbooks & Worksheets When you export a workbook, the system produces a single file that contains data from all worksheets and panels. The Excel version contains a worksheet for each panel in the workbook. In the export, parameters used to generate the data are included with the exported report. To export a workbook or worksheet: 1. Click the workbook document icon and select Export. 2. Select either Workbook or Worksheet. 3. Select Export to Excel. Panels To export an individual panel: 1. Click the panel export icon. 2. Choose Export to Excel. 18 9/16/2009

19 Archiving Reports The Employer Reporting system supports archiving reports. When a workbook is archived, the system stores a snapshot of the data along with the report format or template (panel layout). This feature lets you view the data as it existed at a specific point in time, regardless of corrections that may have been applied in the interim. All Standard Reports are automatically archived each month. When you have any workbook open and choose Save Results from the workbook menu, the workbook will be archived one time (but not each month). You can have your custom reports automatically archived each month by selecting Run Report Monthly from the workbook customization panel. To turn this off, return to the workbook customization panel and deselect the option. Notice that, by default, archived reports have a date stamp as part of their name. The date stamp identifies when the report snapshot was created. They are stored in folders that identify the month that the data was captured. Users may choose to remove the date stamp from their report snapshots when saving them. This practice is not recommended. 9/16/

20 Viewing Masked Data At times, Employer Reporting masks data to protect personal health information or proprietary information. You will see this most often when viewing member or provider data. For most employers, Member IDs displayed in High Claimant reporting are masked. These identifiers are prefixed with asterisks. Other masked data values are displayed as Xs. Numeric values have this format: $XXXX.XX. Masked descriptors are prefixed with Xs and then sequentially numbered. The Future of Employer Reporting Thank you for using Employer Reporting. As an exciting and dynamic new way of accessing your health care data, Employer Reporting will continue to evolve and develop in the future. We invite you to provide your valuable thoughts and insights into this development by logging in and using the feedback link on the Home page. 20 9/16/2009

21 Appendix A Detailed Feature Comparison Feature New System Old System Standard Reports Default Reporting Period Access from Standard Reports section of left navigation accordion. Listed alphabetically. For most reports, Renewal to date. Both the current period & prior periods contain the same number of months. Access from three drop down menus: Financial, Clinical & Enrollment Renewal to date for the current period. Prior period is the full 12 months of the contract period. Custom Reporting Requests processed on demand Requests processed overnight. Mass Customization Mass Export Export Formats Share Custom Reporting Add or Remove data fields from reporting Create new workbook Copy existing reports to new workbook Adjust dates and other parameters Create new workbook Copy existing reports to new workbook Adjust dates and other parameters Export Excel (streamlined format) PDF temporarily suspended until formatting issues resolved Open custom report you own Select Share from document menu Users optionally share custom reports with other users authorized to view an employer s reporting Users can modify existing reporting or build their own reporting from scratch. They have control over elements displayed on reporting. Access Report Maintenance from Tools menu Select reports Adjust dates and other parameters Not Available PDF Excel (format difficult to use) Not Available Not Available 9/16/

22 Appendix B Detailed Report Comparison Report New System Old System Claim Lag Cost Containment Dashboard Enrollment Reporting Experience Reporting High Claimant Reporting Paid Claims Summary Place of Service Summary Default report shows renewal year to date and prior contract year Shows breakout by Coverage Category Shows Medical breakout by Provider Agreement Shows Medical breakout by Product Type Shows Medical breakout by Network Status Contains Paid Claims Overview Contains Utilization & Cost Overview Summarizes High Claimant Activity Defaults to Medical Coverage Shows breakouts by Member Relationship and 3-, 4-, 5- & 6-level enrollment tiers Shows only both contract & member counts Defaults to monthly interval Categories displayed consistently, even if there is no data for period Shows comparison population data for more metrics Variance between current & prior periods is automatically calculated. Claimant ID is masked by default. Can be unmasked for customers who are self-funded and have signed Option A of customer agreement Default reporting shows Medical & Pharmacy coverage only, per customer team Default threshold is $25,000, per customer team Shows claims breakout by age & gender Shows breakouts by Member Relationship Can customize to show breakouts by 3-, 4-, 5- & 6-level enrollment tiers Categories consistently displayed even if there is no data for period. Default shows rolling 24 months of data Restricted to Medical Only Shows breakout by Provider Agreement Not Available Defaults to Medical Coverage Shows breakouts by Member Relationship and 3-, 4-, 5- & 6-level enrollment tiers Shows only member counts, not contract counts Defaults to annual interval Data driven report causes service categories to display only if data exists for the time period Claimant ID is masked for all customers Default reporting shows all coverages (medical, pharmacy, dental & vision) Default threshold is $10,000 Shows claims breakout by age & gender Shows breakouts by Member Relationship and 3-, 4-, 5- & 6-level enrollment tiers Data driven report causes service categories to display only if data exist for the time period. 22 9/16/2009

23 Report New System Old System Specialized Services Summary Stratified Claims Top Medications Top Providers Shows details of Chemical Dependency, Chiropractic, Maternity & Mental Health services. Defaults to paid range, covered range available Shows total paid claims & claimant count for each category, including members with $0 in claims for period Shows cumulative totals Listed as unique standard report By default, displays Top 25 medications; may customize to show top 25, 50 or 100. Can customize report to add Prescription Quantity and Prescriptions with 30+ Day Supply measures Defaults to Medical inpatient & outpatient services More detail available for BlueCard providers; they are listed individually Shows high level summary of all services Shows details of Chemical Dependency, Chiropractic, Maternity & Mental Health services Defaults to paid range, covered range available Shows total paid claims for each category Buried within Pharmacy Experience report By default, displays Top 50 medications; may customize to show top 10, 50 or 100 Calculates member responsibility Displays Total Prescription Quantity, Average Quantity per Prescription and % Dispensing +30 Days Defaults to Medical coverage Pre-built Inpatient, Outpatient, Professional & Other Services reports BlueCard providers shown as single category, often sorted to top of list Utilization by Diagnostic Range Defaults to Medical inpatient & outpatient services. Defaults to Medical coverage Pre-built Inpatient, Outpatient, Professional & Other Services reports 9/16/