Business Analysis Healthcare Domain Classroom & Online Training Mail Id : Skype Id : info.vibloo US: IND:

 Introduction to Business Analysis Introduction to Business Analysis  System Development Life Cycle (SDLC) System Development Life Cycle (SDLC)  Software Engineering Methods - SDLC Software Engineering Methods - SDLC  Requirement Analysis Process Requirement Analysis Process  BA Templates BA Templates  Requirement Elicitation Requirement Elicitation  Business Requirement Gathering Tools Business Requirement Gathering Tools  Use Cases Use Cases  UML Methodology UML Methodology  Business Analysis & Modeling Tool Business Analysis & Modeling Tool  Data Modeling & Techniques Data Modeling & Techniques  QA/Software Testing Overview QA/Software Testing Overview  SQL Overview SQL Overview  Health Insurance Overview Health Insurance Overview  Health Insurance Claims Health Insurance Claims  Health Insurance Sub-Systems Health Insurance Sub-Systems  Health Insurance Transactions and Codes Health Insurance Transactions and Codes  EDI Transactions-I EDI Transactions-I  EDI Transactions-II EDI Transactions-II  Overview of Claim Adjudication Tools and Government Mandates Overview of Claim Adjudication Tools and Government Mandates AGENDA Mail Id : Skype Id : info.vibloo US: IND:

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 Mail Id : Skype Id : info.vibloo US: IND:

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 : Skype Id : info.vibloo US: IND:

Software Engineering Methods- SDLC  Waterfall Method  Rational Unified Process (RUP)  AGILE Methodology  Spiral Model  V-shaped Model Mail Id : Skype Id : info.vibloo US: IND:

Requirement Analysis Process  What are requirements  Requirement Gathering Techniques  Creating Business Requirement Document  Requirement Traceability Matrix (RTM)  GAP Analysis  Impact Analysis  JAD sessions Mail Id : Skype Id : info.vibloo US: IND:

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 Mail Id : Skype Id : info.vibloo US: IND:

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 Mail Id : Skype Id : info.vibloo US: IND:

Business Requirement Gathering Tools  Rational Requisite Pro  Caliber RM Mail Id : Skype Id : info.vibloo US: IND:

Use Cases  Understanding Use Cases  Use Case Relationships  Extended Relationships  Creating Use cases from Requirements  Creating Use case narratives  Change Management & Version Control Concept Mail Id : Skype Id : info.vibloo US: IND:

UML Methodology  What is UML?  Use Case Diagrams  Activity Diagrams  Sequence Diagrams  UML Diagrams Mail Id : Skype Id : info.vibloo US: IND:

Business Analysis & Modeling Tool  MS Visio  Rational Rose Mail Id : Skype Id : info.vibloo US: IND:

Data Modeling & Techniques  Data Dictionary and Glossary  Data Flow Diagrams  Data Modeling Mail Id : Skype Id : info.vibloo US: IND:

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 Mail Id : Skype Id : info.vibloo US: IND:

SQL Overview  Introduction to SQL  Basic SQL queries Mail Id : Skype Id : info.vibloo US: IND:

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 Mail Id : Skype Id : info.vibloo US: IND:  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 Mail Id : Skype Id : info.vibloo US: IND:  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) Mail Id : Skype Id : info.vibloo US: IND:

Health Insurance Transactions and Codes  HIPAA Standards vs 5010  Implementation Guide vs Technical Report Type 3 (TR3)  Type of Codes Used in Health Insurance  ICD-9 vs ICD-10 Coding System Mail Id : Skype Id : info.vibloo US: IND:

EDI Transactions-I  837 EDI Claims; 835 Remittance  Edits and Validations  Reports and Acknowledgements Mail Id : Skype Id : info.vibloo US: IND:

EDI Transactions-II  Other EDI 5010 Transactions  DRG, CPT, HCPCS Mail Id : Skype Id : info.vibloo US: IND:

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 Mail Id : Skype Id : info.vibloo US: IND: