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Reporting for insurers

Business Intelligence with online and interactive reporting

TELUS Health business intelligence tools can provide valuable insights by leveraging a comprehensive database, comprising more than 50% of Canada’s total private health insurance claims. With Business Intelligence you can:

Zone in on relevant data

Retrieve information specific to your customer base, by demographics, drug use, illness or other criteria. With targeted data, you can develop plans catered to your customers.

Identify pain points to refine your service offering

Track trends, from incidences of chronic illness to the impact of aging to manage your plan performance while continuing to meet the evolving needs of your plan sponsors and members.

Build better plans

Inform your strategy with up-to-date information on both historic and current trends. Refine your service offering to optimize program performance.

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Insurers and insurance brokers and advisors offering pay-direct and deferred payment processing for drug claims enjoy both Interactive Reports and Online Reporting tools to help analyze benefit program performance. Data-driven information that supports decision making is critically important in responding to the current economic environment's influence on benefit program sustainability.

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Why you’ll enjoy it

  • Extract, refine and reformat data to analyze it based on variables you choose.
  • Access and retrieve data quickly and reliably thanks to TELUS Health data cubes developed specifically for the group insurance industry.
  • Work with easy to use, self-service capabilities for non-technical users focused on specific health benefits challenges.
  • Bridge the gap between raw data and business insights.
  • Benefit from reporting data that is de-personalized. View data from multiple perspectives and different levels of detail without having to worry about personal health information privacy issues thanks to our cloud based analytics platform.
  • Export reports in three formats: Excel, PDF and PowerPoint.
  • Target any data from the TELUS Health data warehouse for more in-depth analysis by cross-referencing the processed claim data with the plan design data.

 

Benefit from these features

  • Access information that can be adapted to the client's needs.
  • Create specific reports and diagrams, with filters to target an analysis in a focused way.
  • Map claim data with administrative data that define plan coverage.
  • Integrate the latest updated administrative data (coverage history) and apply the updates to all periods impacted by the changes, including past periods.
  • Compare a sponsor's plan with the TELUS book of business.
  • Analyze trends that emerge from several years of historical data.

 

Type of business insights you can get

  • Which diseases within a group plan are most costly, based on drug costs?
  • What are the most common diseases based on claim frequency?
  • How many claimants have claimed drugs for the treatment of specific diseases?
  • What is the average cost of generic drugs, brand name drugs, and innovative drugs?
  • What are the specialty drugs that have been claimed most often over a specific period, and by how many claimants?

 

Get additional management reports through the TIR platform

  • Drug Claims Care Reports identify diseases that affect your plan members the most based on the frequency and cost of claimed drugs.
  • Drug Claims PBM Workbench helps you learn the factors that influence the cost of a prescription drug plan, such as age, geography, industry type and plan design.
  • Drug Claims Pharmacy Reports lets you view the frequency and distribution cost of a drug benefit plan by pharmacy chain and drug source, as well as professional and other fees.
  • Drug Claims Service Monitor allows you to see a summary of the service and administrative issues affecting a drug benefit program.
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Identify trends and patterns of activity with access to dozens of online reports. These easy-to-use tools enable you to select and generate predefined reports. Reports provided include:

  • Group Usage Analytic Reports
  • Benefit Team Productivity and Processing Turnaround Time Reports
  • Audit Reports

 

Over 40 reports are available with selection criteria that are configurable at several levels:

  • Groups/Divisions/Classes (combination or all)
  • Benefit Types
  • Dates and Date Types (date of service or date paid)
  • Reports are exportable in Excel format and include:
    • Summary reports
    • Claims paid by third parties
    • Rejected claims
    • Claims frequency by monthly use and relationship codes
    • Claims by age categories
    • Claims by dollar value
    • Drug category reports
    • Disease category reports
    • Life-enhancing drug reports
    • Top 50 DINs claimed by frequency and amount paid
    • Pharmacy utilization reports
    • Claims paid by exception reports
    • Health Assure Claims Drug Utilization Reports reports
    • Geographical breakdowns
    • Deferred drug claims reports
    • Trial drug reports
    • Prior authorization program reports
 

Here’s what Business Intelligence can do for you

Understand illness and disease prevalence

Identify prevalence of specific illness and chronic disease with robust data on drug use, paired with demographics. With a more profound understanding of member’s health needs, you can refine your drug plan offering.

Quantify costs

Filtering data by time frame, age and more, you can better understand the cost of a prescription plan. Refine your strategy based on facts. Know the 50 most frequently claimed DINs, who paid for them, how old they were, and whether it happened in winter or in summer. Refine results based on where you want to optimize your offering.

Protect customer privacy and gather anonymous data

Get valuable insights from de-identified aggregate level data, while still benefiting from a better understanding of the demographic composition driving claims utilization.

 

More solutions for insurers

My health benefits

Provide plan members with easy access to their benefit plan information and allow them to submit claims via their mobile device or desktop computer.

Claims Exchange

Transmit claims information from the point-of-sale to the TELUS Health adjudication engine and back to the healthcare provider, even if you’re not using a TELUS Health solution.

Business Intelligence Centre for Pharmaceutical

Make data-driven decisions with access to pharmaceutical reports and more

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As a service provider, TELUS Health relies on its insurance-carrier clients to ensure the insurance carriers’ customers, and claimants are aware of the intended use and disclosure of their personal information. They are also responsible to obtain the consent required by applicable law for the use and/or disclosure of such personal information by TELUS Health and its subcontractors in relation to the services to be rendered to the insurance carriers.

Personal information of claimants is to be used and/or disclosed by TELUS Health only for the provision of services contracted by the insurance carrier. All reports prepared for our insurance-carrier client are the property of our contracted insurance-carrier clients. Any dissemination of the reports containing personal information is the responsibility of each insurance carrier client.

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