Case Study

Mitigating Insurance Risk:

Mitigating Insurance Risk:

Pages 2 Pages

Business challenge This healthcare payer used several key systems to feed claim and member files into their central book of record system and associated data mart. This central system, used as the single source of truth for analytics, audit and reporting, lacked a mechanism to ensure data quality and consistency within and between the many source systems that fed its data-- Argus for pharmacy claims, Magellan for behavioral health claims and Facets for medical claims processing. The company needed to ensure data quality in every source system, and also ensure the accuracy, consistency and completeness of data received in the book of record system. Any missing membership or claims information represented a process failure and posed significant compliance, financial and reputati

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