Performance analysis of a health plan

Company X manages health plans and adjudicates health claims for the company ABC.

Company ABC requested a performance analysis of their health plan for a period of 6 months.

As Data Analyst working for Company X, I was asked to:

1. Provide a visual analysis for the company ABC
2. Provide the following calculations: a. Average number of claims per patient per benefit for 6 months period b. Average paid amount per patient per benefit for 6 months period

The visual analysis is displayed in the picture and it includes:

• Paid Amount per Month and Benefit
• Number of Claims per Month
• Percentage of Claim Status (Paid & Reversal)
• Quantity of Submission Method

For the calculations:

• The average number of claims per patient per benefit for 6 months period was calculated like this:

• INT({ FIXED ([Benefit]):COUNT([List of Claims])} / { FIXED ([Benefit]): COUNTD([Certificate (Patient ID)])}

• The average paid amount per patient per benefit for 6 months period was calculated like this:

• { FIXED ([Benefit]):SUM([Paid Amount])} / { FIXED ([Benefit]):COUNTD([Certificate (Patient ID)])}

If you have any questions, please do not hesitate to contact me.