Patient ReadyData - Multi-Payer Closed Claims [SAMPLE]

Reveal insights that make a difference with access to medical and pharmacy touchpoints from 80 payers across commercial, individual, Medicare, and Medicaid plans. Our closed claims data can help you perform more granular analyses and inform decision making with a deeper level of understanding of your target market.

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With Multi-Payer Closed Claims from McKesson Compile™ you'll benefit from:

- Details on payer channel (e.g., Medicare FFS, CHIP, Marketplace) and plan type information (e.g., HMO, PPO)
- Unique details such as comprehensive payment information, chronic condition groups, and patient economic burden
- Frequent data refreshes that happen every other month, so you'll always have up-to-date information

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Patient ReadyData – Open Claims contains 6 tables which include information on:

- Information from medical claims (e.g., diagnoses, procedures, providers, and payers)
- Information from pharmacy claims (e.g., prescriber, product/drug, payers, and status)
- Patient demographic and enrollment information

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Key fields included:

- Claim ID 
- Claim type  
- Episode ID 
- Site of care category 
- Place of service  
- Date of service 
- Patient gender 
- Patient birth year 
- Patient zip3
- Provider NPIs (HCPs – Rendering, Referring, Prescribing, HCOs – Billing, Facility)
- Payer channel 
- Procedure Code
- NDC Code 
- Diagnosis code 
- Fill number 
- Date authorized 
- Claim status 
- Reject codes
- Days supply 
- Number of refills authorized 
- Payer amount paid 
- Patient amount paid, copay, co-insurance, deductible 
- Enrolled month 
- Enrolled year 
- 100+ additional fields available

搜集汇总

背景与挑战

背景概述

该数据集提供来自80个支付方的医疗和药房封闭索赔样本数据，涵盖商业、个人、Medicare和Medicaid计划，支持详细的市场分析。它包含医疗与药房索赔信息、患者人口统计及支付详情，关键字段涉及索赔ID、诊断代码、支付金额等，并每两个月更新一次以确保信息时效性。