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Business AnalysisHealthcare DomainClassroom & Online Training
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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
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 Gov
ernment Mandates
AGENDA
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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
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Mail Id : [email protected] Skype Id : info.vibloo
US: +1-248-436-8449IND: +91-40-3296-5222
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
Mail Id : [email protected]
www.vibloo.com/Business-Analysis-with-Health-Care
Skype Id : info.vibloo US: +1-248-436-8449IND: +91-40-3296-5222
Software Engineering Methods- SDLC
Waterfall Method
Rational Unified Process (RUP)
AGILE Methodology
Spiral Model
V-shaped Model
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Skype Id : info.vibloo US: +1-248-436-8449IND: +91-40-3296-5222
Requirement Analysis Process
What are requirements
Requirement Gathering Techniques
Creating Business Requirement Document
Requirement Traceability Matrix (RTM)
GAP Analysis
Impact Analysis
JAD sessions
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www.vibloo.com/Business-Analysis-with-Health-Care
Skype Id : info.vibloo US: +1-248-436-8449IND: +91-40-3296-5222
BA Templates
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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www.vibloo.com/Business-Analysis-with-Health-Care
Skype Id : info.vibloo US: +1-248-436-8449IND: +91-40-3296-5222
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
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www.vibloo.com/Business-Analysis-with-Health-Care
Skype Id : info.vibloo US: +1-248-436-8449IND: +91-40-3296-5222
Business Requirement Gathering Tools
Rational Requisite Pro
Caliber RM
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Skype Id : info.vibloo US: +1-248-436-8449IND: +91-40-3296-5222
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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www.vibloo.com/Business-Analysis-with-Health-Care
Skype Id : info.vibloo US: +1-248-436-8449IND: +91-40-3296-5222
UML Methodology
What is UML?
Use Case Diagrams
Activity Diagrams
Sequence Diagrams
UML Diagrams
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Business Analysis & Modeling Tool
MS Visio
Rational Rose
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Skype Id : info.vibloo US: +1-248-436-8449IND: +91-40-3296-5222
Data Modeling & Techniques
Data Dictionary and Glossary
Data Flow Diagrams
Data Modeling
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Skype Id : info.vibloo US: +1-248-436-8449IND: +91-40-3296-5222
QA/Software Testing Overview
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
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Skype Id : info.vibloo US: +1-248-436-8449IND: +91-40-3296-5222
SQL Overview
Introduction to SQL
Basic SQL queries
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Skype Id : info.vibloo US: +1-248-436-8449IND: +91-40-3296-5222
Health Insurance Overview
What is Health Insurance?
Why Do We Need Health Insurance?
Health Insurance Coverages
Healthcare Hierarchy
Major Health Insurance Companies
Health Insurance Terminologies
Types of Health Insurance Plans
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Types of Managed Care Plans: HMO, PPO, POS
Key Players in Healthcare
Types of Providers
In Network vs Out of Network Providers
Medicaid
Medicare
Healthcare Glossary
Health Insurance Claims
HIPAA
Protected Health Information (PHI)
What is Health Insurance Claims?
Claims Invoice Types
Mode of Claims Submission
Sample X12
Sample XML
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Sample IRL
Claim Adjudication Process
EDI Transaction Sets Used in Various Industries
HIPAA Transaction Sets
X12 Envelope Structure
X12 Loops and Segments
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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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
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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www.vibloo.com/Business-Analysis-with-Health-Care
Skype Id : info.vibloo US: +1-248-436-8449IND: +91-40-3296-5222