CLORASHealthcareIntegration

Integrating Cloras with Analytics tools for Healthcare

By February 7, 2020 No Comments

Analytics plays a crucial role in any industry, and healthcare is no exception. In this blog, we will look at the importance of connecting and synchronizing data analytics tools with other healthcare applications for smarter healthcare services. We will also delve deep into how CLORAS, an enterprise application integrator, plays a significant role in integrating the same.

Integrating Cloras with Analytics Tools for Healthcare

On a day to day basis, Healthcare businesses need various forms of data analysis such as reports, dashboards, and charts. The outcome of this data analysis will help them to execute the business process and help to improve Healthcare for the members.

Here are a few business processes that can easily migrate to Cloras and create various data analysis outcomes. Analytics tools can easily be integrated with Claims Warehouse to pull all High dollar claims and provide scheduled/on-demand/near real-time reports to the business. Businesses can easily apply filters to these reports through drag and drop via online UI and customize the reports.

Analytics tools can generate Healthcare Reform (HCR) Cost Share Subsidy reports by integrating enrollment and claims and provide the amount of money the Healthcare provider needs to reimburse from Centers for Medicare & Medicaid Services (CMS). The reports can be generated on a high level, as well as a detailed claim level, on a monthly/quarterly basis. Businesses can easily review the dashboards to see how many subscribers were enrolled under Subsidy products as well.

Analytics tools can be used in Sales by integrating with Salesforce to determine Broker commission and how many new accounts were sold in a given month with their member counts. The Sales team can view which Broker brings in the new business and the type of business it is. They can also view how many Brokers have completed their recertification. We can also leverage Analytics tools to generate First Fill reports, which in turn read the claims data warehouse to pull all the drugs which were filled by members for the first time. This will help the primary nurses to evaluate members and educate them on the Care Management program and Disease Management program.

As part of Cross Accum implementation, Healthcare Providers will share more than one Medical claim file per day with the Pharmacy Benefit Manager (PBM), and the PBM in turn will share more than one Rx claim file per day to the Healthcare provider. In order to monitor the file movement and whether those files were successfully generated/processed, we can leverage Analytics tools to create dashboards/reports to provide this information on a scheduled/near real-time basis. Analytics tools can also provide the number of transactions successfully posted in the system, as well as how many have failed.

Conclusion

I hope this has provided you with a brief understanding of the benefits of integrating analytics software with other healthcare applications, and to leverage data for the betterment of the healthcare industry. Please do share your thoughts about healthcare application integration, or if you have any questions related to integration for healthcare, in the comments section below.

Mohideen Kulam

Mohideen Kulam

Mohideen Kulam is a Programmer Analyst/Healthcare Business Systems Analyst working at DCKAP since the past 12 Years. He is an expert in handling Healthcare related projects and has spearheaded many vendor integrations. In particular, he handles intricacies pertaining to Enrollment, Claims, Portals, Billing and Reporting. During his leisure, he likes to read and explore new places.