Transcript Business Analysis Healthcare Online & Classroom Training

Business Analysis
Healthcare Domain
Classroom & Online Training
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AGENDA
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Introduction to Business Analysis
System Development Life Cycle (SDLC)
Software Engineering Methods - SDLC
Requirement Analysis Process
BA Templates
Requirement Elicitation
Business Requirement Gathering Tools
Use Cases
UML Methodology
Business Analysis & Modeling Tool
Data Modeling & Techniques
QA/Software Testing Overview
SQL Overview
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Health Insurance Overview
Health Insurance Claims
Health Insurance Sub-Systems
Health Insurance Transactions and Codes
EDI Transactions-I
EDI Transactions-II
Overview of Claim Adjudication Tools and
Government Mandates
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Skype Id : info.vibloo
Introduction to Business Analysis
 Introduction to Business Analysis
 Roles and Responsibilities of a Business Analyst
 Project Team
 Importance of a Business Analyst in the Project Team
 BA Deliverables
www.vibloo.com/Business-Analysis-with-Health-Care
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IND: +91-40-3296-5222
Mail Id : [email protected]
Skype Id : info.vibloo
System Development Life Cycle (SDLC)
 Introduction to Business Analysis
 Roles and Responsibilities of a Business Analyst
 Project Team
 Importance of a Business Analyst in the Project Team
 BA Deliverables
www.vibloo.com/Business-Analysis-with-Health-Care
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IND: +91-40-3296-5222
Mail Id : [email protected]
Skype Id : info.vibloo
Software Engineering Methods- SDLC
 Waterfall Method
 Rational Unified Process (RUP)
 AGILE Methodology
 Spiral Model
 V-shaped Model
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Mail Id : [email protected]
Skype Id : info.vibloo
Requirement Analysis Process
 What are requirements
 Requirement Gathering Techniques
 Creating Business Requirement Document
 Requirement Traceability Matrix (RTM)
 GAP Analysis
 Impact Analysis
 JAD sessions
www.vibloo.com/Business-Analysis-with-Health-Care
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IND: +91-40-3296-5222
Mail Id : [email protected]
Skype Id : info.vibloo
BA Templates
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Business Case Document
Statement of Work
Project Charter
Meeting Agenda
Meeting Minutes
Business Requirement Document (BRD)
Functional Requirement Document (FRD)
Change Request process document
RTM
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Skype Id : info.vibloo
Requirement Elicitation
 Requirements Discovery Sessions
 Specifying the Activities
 Using Use Case Modeling
 Using Data Flow Diagramming
 Prototyping (Storyboarding, Navigation Flow, Paper prototyping, Screen flows)
 Discovering the Information Requirements
www.vibloo.com/Business-Analysis-with-Health-Care
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IND: +91-40-3296-5222
Mail Id : [email protected]
Skype Id : info.vibloo
Business Requirement Gathering Tools
 Rational Requisite Pro
 Caliber RM
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Skype Id : info.vibloo
Use Cases
 Understanding Use Cases
 Use Case Relationships
 Extended Relationships
 Creating Use cases from Requirements
 Creating Use case narratives
 Change Management & Version Control Concept
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US: +1-248-436-8449
IND: +91-40-3296-5222
Mail Id : [email protected]
Skype Id : info.vibloo
UML Methodology
 What is UML?
 Use Case Diagrams
 Activity Diagrams
 Sequence Diagrams
 UML Diagrams
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US: +1-248-436-8449
IND: +91-40-3296-5222
Mail Id : [email protected]
Skype Id : info.vibloo
Business Analysis & Modeling Tool
 MS Visio
 Rational Rose
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IND: +91-40-3296-5222
Mail Id : [email protected]
Skype Id : info.vibloo
Data Modeling & Techniques
 Data Dictionary and Glossary
 Data Flow Diagrams
 Data Modeling
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IND: +91-40-3296-5222
Mail Id : [email protected]
Skype Id : info.vibloo
QA/Software Testing Overview
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Introduction to QA Methodology
Role of BA in Testing
Creating Test Plans
Creating Test Cases
Creating Test Results
GUI and Unit Testing
System Testing
User Acceptance Testing
Production Testing
www.vibloo.com/Business-Analysis-with-Health-Care
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IND: +91-40-3296-5222
Mail Id : [email protected]
Skype Id : info.vibloo
SQL Overview
 Introduction to SQL
 Basic SQL queries
www.vibloo.com/Business-Analysis-with-Health-Care
US: +1-248-436-8449
IND: +91-40-3296-5222
Mail Id : [email protected]
Skype Id : info.vibloo
Health Insurance Overview
 What is Health Insurance?
 Types of Managed Care Plans: HMO, PPO, POS
 Why Do We Need Health Insurance?  Key Players in Healthcare
 Health Insurance Coverages
 Types of Providers
 Healthcare Hierarchy
 In Network vs Out of Network Providers
 Major Health Insurance Companies
 Medicaid
 Health Insurance Terminologies
 Medicare
 Types of Health Insurance Plans
 Healthcare Glossary
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Mail Id : [email protected]
Skype Id : info.vibloo
Health Insurance Claims
 HIPAA
 Protected Health Information (PHI)
 What is Health Insurance Claims?
 Claims Invoice Types
 Mode of Claims Submission
 Sample X12
 Sample XML
 Sample IRL
 Claim Adjudication Process
 EDI Transaction Sets Used in Various Industries
 HIPAA Transaction Sets
 X12 Envelope Structure
 X12 Loops and Segments
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Skype Id : info.vibloo
Health Insurance Sub-Systems
 Member
 Provider
 Claims
 Prior Authorization
 Third Party Liability (TPL)
 References (All type of Codes)
 Contracts Management (Managed Care)
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Mail Id : [email protected]
Skype Id : info.vibloo
Health Insurance Transactions and Codes
 HIPAA Standards- 4010 vs 5010
 Implementation Guide vs Technical Report Type 3 (TR3)
 Type of Codes Used in Health Insurance
 ICD-9 vs ICD-10 Coding System
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EDI Transactions-I
 837 EDI Claims; 835 Remittance
 Edits and Validations
 Reports and Acknowledgements
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EDI Transactions-II
 Other EDI 5010 Transactions
 DRG, CPT, HCPCS
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Overview of Claim Adjudication Tools &
Government Mandates
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MMIS & Facets
National Healthcare Reform
Affordable Care Act / Govt Reforms
Electronic Medical Records
Healthcare Exchange
Review Templates/Sample Artifacts
Other Mandates and projects
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IND: +91-40-3296-5222
Mail Id : [email protected]
Skype Id : info.vibloo