Page 173 - Ebook health insurance IC27

Sashi Publications

TPA'S l study socio-economic factors
Other stakeholders l data related to disease and health care facility
l frame overall guidelines

Evaluate on performance in terms of
l Claim settlement
l Turnaround time
l Impact of prior authorisation
l Steady trend of claims
l Trend of claims disease wise/region wise

The other stakeholders like brokers, consulting firms,
chamber of commerce, international bodies use data for
publishing reports on latest trends and future prospects.

Basic data elements

IRDA requires insurance companies/TPAs to capture and report data and a specified
format to ascertain that data is collected and reported in a standard format across all the
insurers. Data is covered in the following tables as prescribed by IRDA:-
a. Table A relating to policy information
b. Table B relating to the policyholder information
c. Table C relating to claims information

Data warehousing

Data warehousing is a repository of an organisation's electronically stored data, designed
to facilitate reporting and analysis.

A data warehouse maintains its functions in three layers: staging, integration, and access.
Staging is used to store raw data for use by developers. The integration layer is used to

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