Business Analysis Healthcare Online & Classroom Training

Business Analysis
Healthcare Domain
Classroom & Online Training
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IND: +91-40-3296-5222
Mail Id : info@Vibloo.com
Skype Id : info.vibloo
AGENDA
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
Government Mandates
US: +1-248-436-8449
IND: +91-40-3296-5222

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
US: +1-248-436-8449
IND: +91-40-3296-5222
System Development Life Cycle (SDLC)

Roles and Responsibilities of a Business Analyst
Project Team
Importance of a Business Analyst in the Project Team
BA Deliverables
US: +1-248-436-8449
IND: +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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IND: +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
US: +1-248-436-8449
IND: +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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IND: +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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IND: +91-40-3296-5222
Business Requirement Gathering Tools

Rational Requisite Pro
Caliber RM
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IND: +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
US: +1-248-436-8449
IND: +91-40-3296-5222
UML Methodology
What is UML?
Use Case Diagrams
Activity Diagrams
Sequence Diagrams
UML Diagrams
US: +1-248-436-8449
IND: +91-40-3296-5222
Business Analysis & Modeling Tool

MS Visio
Rational Rose
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IND: +91-40-3296-5222
Data Modeling & Techniques

Data Dictionary and Glossary
Data Flow Diagrams
Data Modeling
US: +1-248-436-8449
IND: +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
US: +1-248-436-8449
IND: +91-40-3296-5222
SQL Overview
Introduction to SQL
Basic SQL queries
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IND: +91-40-3296-5222
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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IND: +91-40-3296-5222
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
US: +1-248-436-8449
IND: +91-40-3296-5222
Health Insurance Sub-Systems

Member
Provider
Claims
Prior Authorization
Third Party Liability (TPL)
References (All type of Codes)
Contracts Management (Managed Care)

US: +1-248-436-8449
IND: +91-40-3296-5222
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
US: +1-248-436-8449
IND: +91-40-3296-5222
EDI Transactions-I
837 EDI Claims; 835 Remittance
Edits and Validations
Reports and Acknowledgements
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IND: +91-40-3296-5222
EDI Transactions-II
Other EDI 5010 Transactions
DRG, CPT, HCPCS
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IND: +91-40-3296-5222
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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IND: +91-40-3296-5222

Business Analysis Healthcare Online &amp; Classroom Training

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Business Analysis Healthcare Online &amp; Classroom Training

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Business Analysis

Introduction to Business Analysis

Health Insurance Overview

Introduction to Business Analysis

Importance of a Business Analyst in the Project Team

System Development Life Cycle (SDLC)

Software Engineering Methods- SDLC

Rational Unified Process (RUP)

Requirement Analysis Process

Business Case Document

Business Requirement Gathering Tools

Business Analysis & Modeling Tool

Data Modeling & Techniques

QA/Software Testing Overview

Health Insurance Overview

Types of Managed Care Plans: HMO, PPO, POS

Why Do We Need Health Insurance? Key Players in Healthcare

In Network vs Out of Network Providers

Major Health Insurance Companies

Health Insurance Terminologies

Types of Health Insurance Plans

Health Insurance Claims

What is Health Insurance Claims?

EDI Transaction Sets Used in Various Industries

Health Insurance Sub-Systems

Contracts Management (Managed Care)

Health Insurance Transactions and Codes

Overview of Claim Adjudication Tools &

MMIS & Facets

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Business Analysis Healthcare Online & Classroom Training

Business Analysis Healthcare Online & Classroom Training