5.6 Diagnostic Trends
The Diagnostic Trend represents how the Plan, Member, and Discount contributions were applied to the total charges submitted by providers per diagnostic category. Each diagnostic category is based on a customizable range of ICD codes.
Diagnostic Trends is designed to simplify the task of breaking down all submitted charges into customized diagnosis categories based upon ICD ranges. The above chart provides a visual colored depiction on the contributions applied by the plan, member and network.
Green - Plan
Yellow - Member
Blue - Discount
The following fields are included in the Diagnostic Trend report :
Category Selection- Click the drop down box to select an individual diagnostic category or use the arrow keys to view each report.
Period - Denotes each quarter represented on the graph.
Claimants - The number of individual members that incurred claims.
# Claims - The number of claims; useful in determining the volume of activity for each quarter.
Plan - Total amount paid by the plan sponsor.
Member - Total amount paid by the member.
Discount - The amount of savings recieved from PPO and other discount outlets.
Total - The total amount billed by the provider before network discount or other types of savings are applied.