The CCLF pivot table allows the user to control the organization of the screens and the data used to populate the screens by using the following controls.
Control #1: Filter
The Filter control is on the control menu at the top of the Claims Pivot Table Front page. This control determines which claims are used to populate the pivot table screens. The default view is the use an intersection of the last 12 months of claims data and the most recently loaded assignment list.
While there are many options for filtering the data by far the most commonly used filters are
- Assigned Quarter: This is the patient to TIN attribution or assignment. The prospective assignment is labelled Q0, the quarterly calendar assignments Q1-Q4, and the final assignment Q9. Some organizations choose to create their own assignments, usually in order to eliminate duplicate CMS assignments. These alternate(A) assignments are labelled Q0A, Q1A-Q4A, and Q9A.
- Claim Date: You have many claim date filter options available to you, all prefixed by Claim Date. The option you select will depend on the type of reporting and the time granularity required. For example if you want all the claims from a single calendar year and only want to view that data at the annual level you would select the "Claim Date | Year" filter. If you want a single year but want to break the data down by a more granular period of time you may select the "Claim Date | Year - Quarter - Month - Date" filter.
When selecting your filters here are a few usage guidelines
- The reporting screen provides additional filtering capabilities. You should use these filters as your base data set filter off of which you would generate other views of the data using the other filters. For example I don't have to use these filters to only include Inpatient claims. I can always filter down to Inpatient claims later. On the otherhand if all I really am interested in looking at are Inpatient claims then it is appropriate to use these filters.
- The filters selections are Or'd when selected within the same filter group and then the various filter groups are And'd. So I if I select multiple months it will use all of those months. If I select multiple assignments it will use a combination of all of the assignments. If I select months and assignments it will only show claims for the claims for the patients in the assignments selected for the claim months selected.
- First select the filter category from the Filter section below. Wait for the list of category options is displayed. Then one by one select the filter you want to apply and wait for it to appear in the Selected Filters list.
- When changing filter sets the previous set will automatically be removed from the Selected Filters section.
Below is a list of the filter categories available to you and an example of the Filters Selected section.
Control #2: Dimensions
The pivot table is a grid of data. Dimensions allow the user to define the X (horizontal) and Y (vertical) axis of the grid and to define a multi-level hierarchy for both axes. The default Y axis is the organizational TIN. The default X axis is the Enrollment Type over Claim Type.
There are so many useful combinations of dimensions that it is difficult to know where to start but here are some commonly used examples.
- Y = TIN over Enrollment Type, X = Quarter over Claim Type
- Y = ICD 10, X = Quarter over TIN
Some usage hints related to dimensions
- This is an extremely powerful tool but requires some trial and error to get a feel for how to best organize the data to get the desired results. Before starting to do the dimension configurations it is always a good idea to think about what you want the end result to look like.
- While you can have multiple levels of dimensions, there are practical limits. All of the combinations of rows and columns mean that each one of those cells must be calculated and populated which can either take a long time or may result in the report timing out. So if you do need to chose a lot of dimensions you should consider 1) filtering the data set down significantly per Control 1 and/or 2) using the grid filters to narrow down what is being displayed in the grid.
- The dimension selections are applied by clicking on the up arrow (X axis) or the left arrow (Y axis). They are applied in the order of selection with the first selection for the axis being the top dimension and the last one being the bottom dimension. To make sure you are arranging everything the way you want it to look you can deselect all the dimensions currently configured, select what you want in the order you want them, and click update.
- When viewing the results in the grid you will often see some values associated with a row or column labelled Unknown. This is an indicator that we do not have enough information to put that data into a defined row or column. For example we receive come claims which do not have a Claim Type defined. If you have a Claim Type dimension these claims would be in the Unknown category.
Below is the full list of the Dimension options.
Control #3: Measures
The filters and dimensions defined in Controls 1 and 2 are all about configuring what is used to populate the Measure cells. Measures are calculated cells which show up as columns under the X axis dimensions. The default measures are Cost Per Patient, Claim Count, and Patient Count.
Measures usage is relatively straight-forward but here are a few explanations that may be of use
- It is important to understand the difference in Patient Count and Claimant Count.
- Patient Count will vary dependent on a patient-specific attribute. For example, each patient has one and only one Enrollment Type. So under an Enrollment Type dimension you would get the number of patients with that enrollment type. However Claim Type is not a patient attribute, it is a claim attribute. The Patient Counts under your Claim Type dimension will not vary from claim type to claim type.
- Claimant Count is a count of the number of patients who have a claim which meets a claim-specific criteria. If you have a Claim Type dimension the Claimant Count will from from claim type to claim type.
- The Episode-based measures are not exact as all of the information needed to calculate them is not in the claims.
- Count-based measure values are clickable links which take you to a "drill through" list of patients or claims associated with that number. If I have a value of 5 under Claimant Count under Home Health, I will see a list of the 5 patients who had home health claims.
Below is the full list of the Measures options.