I lead the initiative to design this document and the via a webinar to the community of users when CMS upgraded the version of Business Objects that was being used. It covered what would be the most commonly used features from the upgrade. This information was also posted to the community portal for all users to access as a reference guide. 1

One PI Overview — Course Topics Overview of One PI Vision Goals and Benefits Data Environments Query Tools Comparison Data Review Portal Basics One PI Portal and Features Portal Computer-Based Training

One PI Overview — Course Objectives After completing this course you should be able to describe: Goals and benefits of One PI Differences between the current data environment and the One PI data environment Features of the One PI Portal Features of Business Objects and Advantage Suite Data that is loaded into One PI Data availability for Business Objects and Advantage Suite Reference materials available for One PI users

One PI Overview — Vision One PI Vision To provide a secure, centralized environment containing current, consistent, and integrated Medicare and Medicaid health benefits data, analyzed with standard tools, to detect fraud, waste, and abuse and protect health care expenditures.

One PI Overview — Goals and Benefits Improve access, availability, and timeliness of data Eliminate data redundancy Enhance communications and collaboration Access to data - tools that allow focus on fraud, waste and abuse detection rather than complex coding Integrate Medicare, Medicaid, provider and beneficiary data

One PI Overview — Current Environment

One PI Overview — Objectives Based on Requirements Key Requests Comprehensive data Variety of tools (e.g., report writer, analytics, etc.) Ability to schedule reports and create non-standard reports Single source of data Fast system response times Collaboration features End-user support

One PI Overview — Future One PI Environment 8

One PI Overview — Business Objects and Advantage Suite Features and Functionality Drag and drop Standard reports and templates availability Ad hoc reporting capability Graphs and charts Advanced scheduling and report distribution (i.e., alerts) Reference data Ranking Provider and beneficiary Procedure code and HCPCS Scoring User-defined thresholds Export to .xls or .csv file types 9

One PI Advantage Suite — Additional Functionality 2500+ healthcare measures Patient health records Clinical intelligence Admissions and episode groupings Predefined subsets Clinical conditions Relative time periods Metadata catalog Dynamic benchmarking List import Additional data elements Relative Value Unit (RVU) assignments Therapeutic class and group 10

One PI Business Objects — Additional Functionality Combined queries Historical data and access to the three phases of claims (pre-adjudication, adjudication, and final action) Access to all data elements in the Integrated Data Repository (IDR) Data available immediately once loaded in the IDR User prompts Use of report formulas (similar to Microsoft Excel) 11

One PI Data Review — Which Tool Should I Use? Business Objects is often used when you want to: Access the most current information available in the IDR for up to date fraud, waste, and abuse analysis Access a majority of data elements available in the IDR (2000+) Access all occurrences of a claim record 12

One PI Data Review — Which Tool Should I Use? Advantage Suite is often used when you want to: Analyze DME claims grouped by Medicare DME Policy Groups Utilize Admissions and Episodes Compare your providers to their peer groups on a risk-adjusted basis Leverage the financial, utilization, or clinical measures available in Advantage Suite Utilize predefined relative time periods 13

One PI Data Review — What Future Data Will Be Available in the IDR? Shared Systems data, including additional data elements such as: Check Number Check Date Check Amount Edit/Audit Reason Codes Billing Provider 14

One PI Data Review — Where Do I Find Information About My Data? Quick reference guides and other reference materials available on Portal: ‘One PI Data Element Reference Guide’ ‘Advantage Suite Quick Start Guide’ ‘Helpful Hints’ ‘Financial Fields’ ‘Customer Favorites’ One PI Coaches for assistance in developing reusable templates, subsets, etc. Your PIDUG community. This is also where you can provide feedback on the need for additional Quick Reference Guides 15

One PI Overview — One PI Portal Overview The One PI Portal provides access to: Data tools Document management and collaboration tools User support Help Desk Computer Based Training Security Multi Protocol Label Switching (MPLS) service network Monitored and Managed by AT&T Role-based security Change log: V.1.6: 9/10/10 – Changed bullets from: Medicare Data Communications Network (MDCN); Secure, closed, private network managed by AT&T TO: Multi Protocol Label Switching (MPLS) Service Network ; Monitored and Managed by AT&T

One PI Overview — One PI Portal Overview One PI Portal features include: One PI announcements Links to law enforcement resources Health and Human Services (HHS) Office of Inspector General (OIG) Exclusion Program HHS OIG reports HHS OIG fraud alerts and bulletins Program Integrity Data Users Group (PIDUG) community news, alerts, and collaboration tools Document sharing

One PI Overview and Data Review — Summary We hope you walk away with a better understanding of: The One PI vision and current state The IDR and how it is sourced How the IDR feeds Business Objects and Advantage Suite The unique aspects of Business Objects and Advantage Suite The One PI Portal and its features 18