4.7 Diagnosis Analysis

Claims Review includes two reports that provide analysis based on the diagnostic information included in claims: Diagnosis Analysis and Lifestyle Analysis. Both reports are based on the International Classification of Diseases (ICD) diagnosis coding system and provide a set of categories made up of multiple ICD code ranges.

Code ranges for both diagnosis and lifestyle categories may be customized. Please see ICD9 Code Set section.

Claims review diagnosis analysis

The graph displays how much the Plan Sponsor (green) and member (yellow) paid as well as the amount of savings obtained through network discounts (blue); the top of each bar represents the total original charge billed by providers. The numbers along the bottom of the graph can be matched back to the number (#) column in the table.

**Note that clicking on a specific diagnosis category drills down for further claims investigation. Please refer to the Drill Down section.

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