PowerPoint Presentation

[Audio] Welcome to the RIA Fully Insured Reporting and Data Analytics Tool Demonstration. This tool is designed to work with ORMB..

[Audio] The agenda of this demonstration is to know and understand the key objectives of the RIA reporting tools and it's need followed by an overview of the product capabilities. Then we shall proceed to the high-level overview of the architecture explaining the framework of the product followed by the product demo showing the dashboards and reports. We shall also see the admin tool which allows for the configuration of the database coming for reporting..

[Audio] The Key objective of the RIA reporting tool is to enhance the Revenue Management experience by modern reporting, analytics, digital experience, etc. This reporting tool also Implements revenue management systems and perform health check on existing implementations, leveraging our deep product expertise and process knowledge of various industries, Advises clients to implement best in class revenue management systems, define end to end strategy, build processes and governance, find ways to improve customer experience. Not only that but it also manages Secure, safe, efficient cloud-based application management service, from hosting to implementation, SLA based model providing business continuity assurance and generates Products that accelerate implementations, for automated testing, data migration, large-scale data generation for performance testing..

[Audio] Here is a list of some of the prominent organizations where the RIA reporting and data analytics tool is being performed and implemented across multiple industry verticals..

[Audio] RIA has come up with a powerful reporting and data analytics solution that optimizes data models through pre-built starts & schemas for analytical processing, slicing & dicing of data which are Utilized by other healthcare companies bringing reporting best practices to the solution. It can be dealt and maintained easily and supports lower total cost of ownership. Ease of front-end report creation and Faster speed to market are some of its plus points. This tool is Pre-integrated with Oracle Revenue Management & Billing solution enriching the ORMB data with information from auxiliary systems to provide enterprise reporting..

[Audio] The pain points or challenges faced by the organizations are the Timely availability of accurate data to meet the information needs of different role players in the organization, High turnaround time for any changes or addition to existing reports and/or data structures, Close monitoring of Clients and Products usage and behaviors to take corrective actions in time, when needed, Reporting needs to run near-real time multiple times a day due to the dynamic nature of billing workflows, Holistic data view i.e., a single repository for consolidated data insights, Reporting data is not fully hosted in a revenue management system, hence needs to integrate with multiple sources, System like ORMB is an OLTP database ( 400+ tables) and running reporting on its normalized database is inefficient..

[Audio] Here are few of the objectives of the Fully Insured Reporting product: Persona based reports based on near-real time data sourcing from ORMB or similar data sources to RIA Reporting & Data Analytics using in-built mini batch mechanism Architecture supports new characteristic type addition, removal and changes without any code changes Standardized dashboards for different business functions comprising trends, variances, etc. targeting specific areas Easily adoptable business models for self-service reporting & ability to generate point in time reports Architecture supports third party data amalgamation without any code changes Start Schema data structure with schemas designed to inline with Revenue Management subject areas Reports & Dashboards for multiple LOBs in the FI Reports and Dashboards in the same product Configuration driven ETL.

[Audio] Moving further, let us focus on the features of the product..

[Audio] The Fully Insured Reporting tool Translates complex & granular ORMB data into a logical business interpretation for smart decision making, for all segments of the organization. It provides Graphical & Interactive display of customer, product, system and key KPIs, with ability to drill-down to multiple levels. It has a Simple, powerful & user-friendly GUI to administer, manage, monitor & custom report creation. It has the Ability to expose reports & dashboards through self service portals. Not just one but more than 35 out-of-the-box reports & dashboards are available providing real time data replication for most operational, financial and client-facing reports..

[Audio] Moving on to the product features and capabilities. The tool allows the Ability to capture changes and transform data from ORMB source to RIA DATA LAKE inreal time. The tool also gives the ability to execute mini batches to populate data in Data Mart in incremental fashion. So rather than having to duplicate all the data, the tool is able to see and show what is changed, so we can incrementally copy the data into the reporting table. It also provides the ability to process new characteristic type without code change. This will help speed up the reporting changes. So instead of having to design the whole new report you can just very quickly add a characteristic and this will be shown in the admin tool. The tool also Integrates 3rd party with ORMB data. We're talking about 3rd party data here which can be any data that is outside of ORMB. So any of your sources like claim system and you wanna combine that with your ORMB data so you can report from just one set of tables. It also allows to generate point in time reports. So for instance for any financial needs or any audit needs you can always generate a report. And also has the capability to drill across multiple subject areas..

[Audio] This product has various technical as well as business related benefits. The Financial transactions, customer comparison, transaction processing, account activity, trend analysis, audit and reconciliation and various strategic decisions based on Real Time Business Insights can be taken efficiently..

[Audio] Let us have a high level overview of the architecture. RIA Data Analytics is built upon 3 key components, Replica database, ETL Framework and Datamart. So here you have got the ORMB database which captures all the data that is in ORMB like the pricing and billing data, the claim transactions, so all of this data will be replicated into the replication tables. Raw data from Replica database is then simplified in Star Schema format using Talend ETL jobs. From there we have the mini batches which will take your replicated data and dump that into the data mart. Then from this data mart, the visualization tool will be used to generate the dashboards and reports. And as we mentioned the third part data down there or any other data other than ORMB which you would like to report can be sent in and the ETL mini batch process will be used to increment and note the changes and put that into the data mart. The same ETL tool can also be programmed to insource and churn data received from other data sources in the organization. So you will notice that the ORMB data and the third party data is able to come in and then you can report after that into the data mart. ETL loads the dataset into Datamart which contains Facts and Dimension tables for all the incoming tables and fields. Data in the datamart can then be sliced and diced to produce summary tables and views based on the reporting requirement. Summary tables and views can be integrated to organization's reporting portals..

[Audio] The next thing that we're going to discuss before we get into the actual demo is the ETL or the Talend Batch Process. So this is the mini batch process that we discussed where it takes the data from the replicated table and put it into the data mart. This ETL process developed in Talend will load data from replicated tables to a purpose-built star schema or Data Mart. Summary tables are created for targeted complex queries to help simplify the reporting process and these ETL jobs can be scheduled using Cron or any other scheduling tools and you can set this on any frequency you need, every 10, 15 minutes or hour depends on your needs. You can use the tools to match your schedule. And then finally The Data Mart consists of Facts, Dimensions & Summary Tables..

[Audio] Let us now have a look on the metadata tool of this product..

[Audio] RIA Datamart has a set of prebuilt Subject areas. In ORMB, billing is considered as a subject area, similarly payment and adjustment are separate subject areas. So there are various subject areas..

[Audio] Configuration Metadata tables will allow to integrate characteristic values into Datamart as a configuration item. Finance related reports requires data from multiple subject areas. Common keys to drill across multiple tables (Aging report uses common keys between Payment, Bill & Adjustment). Ability to add additional Measures & Attributes to existing Fact & Dimension tables to eliminate the need for Joining multiple Fact tables. RIA data Mart has implemented flexible architecture to solve this problem which is the Metadata Configuration Framework. MetaData Configuration is a configurable framework which allows users to configure the various data columns that have to be brought into the reporting system. Generally, in a normal data warehouse wall a particular code has to be written in order to insert the data from tables into the data warehouse and then report the data. But here we provide a configurable option where the user can go into the framework and add any column from the table into the data warehouse just by a single click. It lists out all the columns from the table and loads the desired column into the data warehouse. All the user has to do is configure the data as hence this is known as configurable ETL framework which improves the speed of transferring the data to the market on the ETL delivery. This can be done by any super user or business user. Thus, a super user who understands their requirement, their dataset can handle this. The main motive of this configurable framework is that the user does not need to fetch any IT help. One can do it on their own without any help as long as the business super user who has a good understanding of their business needs..

[Audio] These reports and dashboards are available for different types of users and the admin console is only for specific small subset of users, only superusers. For example: As it is shown on the framework, the account table has limited columns which are all configured. These are the attributes of ORMB. So if the customer finds a need on some other attribute or parameter and want to generate a report, all they need to do is save the attribute. On saving, the data gets loaded in the tables going forward and the reports can extract that data and show off desired parameter information instead of going through the entire development life cycle process. Thus at the click of a button, the attributes that are required can configured and added accordingly. Sometimes ORMB itself adds a new characteristic. ORMB allows you to add as many number of characteristics you want. And when that happens, the business people want that column to be added in their ETL process. They have to open a change request to the ETL, they have to go through the entire development life cycle and then finally put into the production. But through this configurable framework we can avoid all the development life cycle and just configure the required parameters and automatically the ETL will know which columns have to be added and it will start loading the new elements to the data warehouse. When we replicate the data from ORMB database the data can be taken from the report related tables which are 275 out of 2000 reports in ORMB. The RIA data mart is created from the data from these 275 tables. Now within this data mart, there are particular tables and their attributes and their mapping that is done by the superuser. Thus, there's no ETL work involved here, it is all configurable. So, we call it as a configurable framework which enhances the speed to the market..

[Audio] Here we will be viewing the financial healthcare dashboard and the fully insured premium dashboards..

[Audio] RIA Reporting and Data Analytics comes with multiple out of the box reports and dashboards built on multiple reporting tools - Click View, BI publisher, Cognos etc. These are ready to use yields which can be implemented right from day one, post implementation. These report cover most of the generic functions and data points used typically by an organization. Here we have the accrual reports, billing reports, payment/adjustment reports, other subject areas and the management dashboards..

Appendix.

DEMO - Reports. List Of Reports. List of reports.

[Audio] Whether it be any insurance or healthcare organization, it is the ageing reports and the invoicing reports that most of the organizations would need to alleviate a lot of issues for senior product owners or other such posts in the respective organizations. The Financial Dashboard Healthcare has the entire story of the frozen Financial transactions that includes payments, bills and adjustments. The entire dashboard is divided into 4 widgets which is the standard presentation seen by every user irrespective of it's post. This is how the business user is going to look into it. The widgets are: 1. Billed Revenue by Accounting Month 2. Late Payments by Accounting Month 3. Recoupment Request by Accounting Month 4. Aged Receivables by Accounting Month This master dashboard containing 4 widgets is the highest level and then each widget can be drilled further to the detailed dashboards. In ORMB, billing is considered as a subject area, similarly payment and adjustment are separate subject areas and aging is derived from these 3 subject areas. The dashboard can be viewed for a particular selected date or month which the user can select on the basis of the date parameters at the top right-hand corner of the dashboard. One can select YTD (Year to Date) or MTD (Month to Date) or can even set the parameter to last 12 months for viewing the dashboard for that particular period, last month or last 7 days. By default, the date parameter is set to YTD. The dashboard immediately changes the view as soon as we change the date parameters. Below the date settings is the providers list to have a look at a particular customer or a provider. In this case one can select an individual provider or a set of providers. Whenever any parameter is selected, it is the entire dashboard that witnesses a drill across all the widgets and not a single widget. So, when you select a global filter, the filter is applied to all the widgets. The 1st widget in the dashboard is the Billed Revenue by Accounting Month. The KPIs for this widget are - Year to Date (YTD) Revenue, Current month billed revenue, total aging amount indicating how much amount is not being paid and the Days sales outstanding which is a key metric indicating the average aging of the bill. (It is a universal metric that every organization uses. So if a single invoice has been issued, the payment average takes the number days to reach the person by value as given in this section). So, the Billed Revenue by Accounting Month is presented using 2 metrics. The 1st being the accounting month and the 2nd being the customer class. It also shows the number of invoices for each customer class. So, the billed amount and the no. of invoices by the customer class is displayed by the 1st widget. The user can drill down further from the respective customer class to its individual providers. (And these providers are the customers that have been billed) which can be further drilled upto the individual level. Thus with the help of this widget, one can drill down from accounting month to customer class to individual customer provider. Recoupment Request is a kind of an adjustment done by the vendor or the government related to the premium write-offs because of the losses incurred due to some catastrophic events providing a waiver on the premium. The next widget is the Aged Receivables by Accounting Month. So, this widget shows the amount of receivables present and the amount that is being aged in the different buckets as shown in the widget. Now one can drill to a specific medical insurance which is shown in the Fully Insured Premium dashboard. This widget can be viewed in detail by clicking on the button below which takes you to the detailed billing dashboard showing the revenue breakdown geographically..

[Audio] This dashboard consists of 4 widgets. This gives the details of the billing data in geographical terms answering the questions, Where is my billed amount? In which particular region is my billed issued? It shows the revenue breakdown by regions, so it can be drilled from the country to the state level and from state it can be further drilled to the county level. So, the geographic capabilities can be drilled down using this dashboard. The type of audience that will be interested in this dashboard will probably be a cash analyst or someone into AR. We know that each company has be a separate group that deals with finance like billing and payment and this board will fascinate the ones who will be interested in looking at the financial dashboard healthcare. The graphs below the geographic map are: Revenue Variance – Current month vs Avg of last 6 months Billed Revenue by contract type Billed Revenue by Accounting month Revenue Variance – Current month vs Avg of last 6 months – indicates the amount billed on an individual provider in that current month as compared with the last 6 months. As it is seen, there are top 5 customers whose bill amount is compared with that of their last 6 months which results in 5k variance i.e. $ 5k more was billed compared to the avg of the last 6 months. This graph helps to find out the billing errors present. Accordingly, there can be positive variance and negative variance too. Negative variance indicates the customer has been billed less compared to the last 6 months average due to some reasons. This can be identified if there are any billing errors in terms of while generating the bill. The next graph is that of the Billed revenue by contract type, which helps in viewing every product in detail i.e. it shows the revenue breakdown by contract type. Billed revenue by accounting month shows the revenue or bill amount for the current coverage period, future coverage period and for the retractive coverage. While billing, one can bill considering the past dates that have been missed out in the previous bill or can also consider future month or upcoming month and thus bill for coverage period respectively. This graph tells the bill amount in accounting month belonging which month coverage i.e. the current, past or future. This information helps in generating one of the important reports that the finance team will be closely looking at it as they will be wanting to know to which coverage period was amount added to do their balance sheets. The bottom axis explains the date range for each coverage period. Going back to the master dashboard, we have the next widget which is the late payments by accounting month..

[Audio] This widget explains the payment tender amount received and cancelled by tender source type. The different tender sources and the amount that was cancelled is displayed in this widget. There are different tender sources like auto pay, cash, log box. For example: $ 116.5k was recieved through autopay and $ 21k was cancelled from it. This information can also be displayed separately as payment tender amount received by tender source type and payment tender amount cancelled by tender source type. One of the important features of this widget is that this information can also be obtained in the pdf format. The upper two widgets show the amount of payment received and the amount being cancelled from it. Now when a payment is received it is not necessarily applied to a bill. The payment can be on the account, awaiting to be adjusted to the bill or the respective account. Thus, the amount goes to a general suspense account. So, the payment amount by accounting month displays the payment received through different tender sources and its application..

[Audio] The receivable dashboard shows all the amounts that has been billed, the amount that has been paid and the adjustments that could've been done on the bill. This is followed by a bar chart which shows the cumulative aged amount. Below is the Pending Receivables by Customer's Longevity which is an example for the pending receivables and the customers who are defaulting the bills. (So as per this, the people who are more than 20 years customers are defaulting on the bills and the least is with the ones who are 10-20 years customers. It means that the customer for more than 20 years has not paid 14 invoices of a total amount of 19k dollars.) The date range for a particular group is shown in the block form at the aged receivables widget. So, there are various customer classes and you actually can drill down a particular customer class..

[Audio] The Fully Insured Premium Dashboard shows the premium by HCC( Health Care Category) which is for vision, dental and medical categories. Below it is the Fully Insured Premium by Plan Type. Here the standard medical healthcare plans have been considered like Preferred Provider Organization, Point-of-Service and Health Maintenance Organization. It is talking about amounts by each plan type. These are the standard healthcare plans. Beside it is the graph section for the Fully Insured Plan by Tier. 4 tiers have been considered which are single, single and dependent, single and spouse, and family. Beside it is the Premium Holiday and Disaster Relief Exclusion. The concept behind this is that the company healthcare provider can write-off premium to an old customer as he is facing some serious financial issues. So the company can grant a waiver to that customer's premium for the next few months according to the company. Whereas relief exclusions are write-off given to the customers' premium due to a national disaster as designated by the federal government. So in such cases the provider can actually write-off the premium that comes under the disaster relief exclusion. Both are the premiums written off to the customers, one is voluntarily provided by the vendor and the other is provided by the government..

[Audio] Then comes the Enrolment count by HCC which has vision, dental and medical enrolments. Enrolment count by Plan Type and enrolment count by Tier. The entire Claims summary by Coverage Period is given at the end of this dashboard..

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