User Guide: Medical Analytic Report

USER GUIDE: MEDICAL ANALYTIC REPORT

OVERVIEW

Why?

With the consistent rise of medical inflation, FGV is struggling to have healthcare costs for the
employees managed well.
Not only that, overcharging and fraud bills are often left undetected.

How?

Medical analysis shall be done by generating data from PMCare Medifile platform.
To access, login to: https://www.pmcaremedifile.com.my/

PLATFORM FOR MEDICAL ANALYTIC REPORTING

PLATFORM FOR MEDICAL ANALYTIC REPORTING

Login to: https://www.pmcaremedifile.com.my/

IMPORTANT NOTE:

 Access to this platform
shall be given only to
HRBP and person in
charge for medical .

 Registration/
Termination of access
shall be made via
Group Rewards.

 To login, personal FGV
official email should be
used. Password for
first time login were
default to “PMCare888”
and shall be changed
upon for login.

PLATFORM FOR MEDICAL ANALYSIS

Choose Report > Details of Utilisation > Start Date & End Date > GENERATE

IMPORTANT NOTE:

 Details of Utilization
shall be excluded
“Incurred But Not Re-
ported” (IBNR) trans-
actions.

Start & End Date
to be generated

PLATFORM FOR MEDICAL ANALYSIS

Choose Report > Details of Utilisation > Export to CSV

IMPORTANT NOTE:

 To select start date &
end date for details of
medical utilization.

 Select “Export to CSV”
instead of “Export to
Excel” to maintain the
report formatting as
per displayed in the
web. Save as Excel
(Excel Binary Work-
book)

PLATFORM FOR MEDICAL ANALYSIS

Choose Insert > Pivot Table > Add Data to Data Model

IMPORTANT NOTE:

 A Pivot Table is used to
summaries, sort, reor-
ganize group, count,
total or average data
stored in a table.

 Pivot Table also allows
us to transform col-
umns into rows and
rows into columns.

MEDICAL DATA ANALYSIS (COMPARISON)

MEDICAL DATA ANALYSIS (COMPARISON) IMPORTANT NOTE:

Medical Report Selection in Pivot Table:

Steps to generate data on: A) Filter Section
i- Total medical cost (inpatient & outpatient) - select “Company Names”
ii- Total number of treatment/ visits
iii– Number of employee/dependent seeking (for analysis more than 1 Company)

treatment B) Rows Section
- select “Claim Types”

C) Columns Section
- select “Service Year”

D) Values Section
- select “Staff Code > Distinct
Count”
- select “Approved Amount >
Count”
- select “Approved Amount >
Sum”

MEDICAL DATA ANALYSIS (COMPARISON) IMPORTANT NOTE:

Approved Amount By Service Type SBeasleecdtion tohfeCdhatrat generated
t1oC.anoSblpeuleilmve, oscntet/ltIBenaacsbrtelerCt,hi>anrsIntes>ret2rtDthe pivot
Based on the data generated on pivot table , select insert “Column/Bar” chart to convert data into chart visual. Stacked Column

2. Select Add Data Labels—to
display figures

A)

MEDICAL DATA ANALYSIS (COMPARISON) IMPORTANT NOTE:
BSeasleecdtion tinhePdivaottaTgaebnle:rated
Approved Amount By Employee Category A-otan)sbepFleliievl,tcosetter“lteSaScebetrlcevti,icoiennsYeeratrt”he pivot

Based on the data generated on pivot table , select insert “Pie/ Doughnut” chart to convert data into chart visual. B) Rows Section
- select “Staff Category”

AC)) Values Section
- select “Staff Category >
Count”

Selection of Chart:
1. Select Insert > 3-D Pie
2. Select Add Data Labels—to
display figures

MEDICAL DATA ANALYSIS (COMPARISON)

No of Treatment vs Approved Amount By Employee Category

IMPORTANT NOTE:

SBeasleecdtion tinhePdivaottaTgaebnle:rated
Ao-tan)sbepClelieov,closuttem“lteSancbtsatlefSf,eCicnatstieeogrnot rthy”e pivot

B) Rows Section
- select “Service Year”

AC)) Values Section
- select “Approved Amount >
Count”
- select “Approved Amount >
Sum”

Selection of Chart:

1. Select Insert > Create Cus-
tom Combo Chart

MEDICAL DATA ANALYSIS (COMPARISON)

No of Treatment vs Approved Amount By Service Types

IMPORTANT NOTE:

SBeasleecdtion tinhePdivaottaTgaebnle:rated
-Atoan)sbepClelieov,closuttem“lteSancebstrlevSi,eciecntsYieoernatrt”he pivot

B) Rows Section
- select “Service Type”

C) Values Section
-A)select “Approved Amount >
Count”
- select “Approved Amount >
Sum”

Selection of Chart:

1. Select Insert > Create
Custom Combo Chart

2. Under Chart Type > to
select line & clustered
column.

MEDICAL DATA ANALYSIS (COMPARISON)

No. of Treatment by Company

IMPORTANT NOTE:

SBeasleecdtion tinhePdivaottaTgaebnle:rated
tA-oan)sbepClelieov,closuttem“lteSancebstrlevSi,eciecntsYieoernatrt”he pivot

B) Rows Section
- select “Company Name”

AC)) Values Section
- select “Approved Amount >
Sum”

Selection of Chart:
1. Select Insert > Column/Bar
Chart > 2D Bar
2. Select Add Data Labels—to
display figures

MEDICAL DATA ANALYSIS (COMPARISON) IMPORTANT NOTE:

Approved Amount by Company SIeMlePcOtRioTnAiNnTPiNvOotTTEa: ble:
AB)aCseodluomnntsheSdeacttaiognenerated
-osnepleivcott“Staebrlveic,einYseearrt”the pivot
table, select
B) Rows Section
- select “Company Name”

C) Values Section
- select “Approved Amount >
SAu)m”

Selection of Chart:
1. Select Insert > Column/Bar
Chart > 2D Bar.

To Change Legend Position:
1. Right click on the legend &
select “Bottom”.

To Include Percentage Diff:
1. Manual insert in Power Point.
Select “Insert > Text Box”

MEDICAL DATA ANALYSIS (COMPARISON) IMPORTANT NOTE:

Top 5 Diagnosis ISMePleOcRtioTnANinTPNivOoTtET:able:
BAa)sCeodluomn tnhseSdeactatiognenerated
-onseplievcott “tSaebrlevi,ciensYeeratrt”he pivot
Bta)bRleo, wsesleScetction
- select “Diagnosis Code”

C) Values Section
- select “Approved Amount >
Count”
A)
To filter Top 5 Diagnosis
1. Copy pivot data & paste as
number.
2. Select Home > Sort & Filter
> Top 10 > Setting to Top 6.
3. “VLOOKUP” to determine
the “Diagnosis Name”
4. To calculate %, no. of se-
lected treatment divided with
total no. of treatment.

MEDICAL DATA ANALYSIS (COMPARISON) IMPORTANT NOTE:

Utilisation by Month ISMePleOcRtioTnANinTPNivOoTtET:able:
ABa)sCeodluomn tnhseSdeactatiognenerated
o-nseplievcott “tSaebrlevi,ciensYeeratrt”he pivot
tBa)bRleo, wsesleScetction
- select “Diagnosis Code”

C) Values Section
- select “Approved Amount >
Count”
A)

Selection of Chart:

1. Select Insert > Create
Custom Combo Chart

2. Under Chart Type > to
select line & clustered
column.

OVERALL COST BY YEAR

OVERALL COST BY YEAR IMPORTANT NOTE:

Overall Cost by Staff Category ISMePleOcRtioTnANinTPNivOoTtE:Table:
ABa)sFeildteornsthSeecdtaitoangenerated
o-nseplievcott “tSaebrlevi,ciensYeeratrt”h&e pivot
“taCbolme,psaenleycNtame” (applicable
for more than 1 company)

B) Rows Section
- select “Staff Category”

C) Values Section
-A)select “Approved Amount >
Count”
- select “Approved Amount >
Sum”

Selection of Chart:

1. Select “Insert Pie/Doughnut
Pie Chart > 3D”
2. Select Add Data Labels—to
display figures/percentage

OVERALL COST BY YEAR IMPORTANT NOTE:

Overall Cost by Types of Treatment ISMePleOcRtioTnANinTPNivOoTtET:able:
ABa)sFeildteornsthSeecdtaitoangenerated
o-nseplievcott “tSaebrlevi,ciensYeeratrt”h&e pivot
taCbolme,psaenleycNtame”

B) Columns Section
- select “Claim Type Code”

C) Rows Section
- select “Service Type”
A)
D) Values Section
- select “Approved Amount >

Sum”

Selection of Chart:
1. Select Insert > Column/Bar

Chart > 2D Column
2. Select Add Data Labels—to

display figures

OVERALL COST BY YEAR

Overall Cost by Relationship Group

IMPORTANT NOTE:

Selection in Pivot Table:

A) Filter Section
- select “Service Year” &
“Company Names”

(for analysis more than 1 Company)

B) Rows Section
- select “Relationship Group”

C) Values Section
- select “Approved Amount >
Count”
- select “Approved Amount >
Sum”

Selection of Chart:
1. Select Insert > Column/Bar
Chart > 2D Bar.
2. Select Add Data Labels—to
display figures/percentage

OVERALL COST BY YEAR

Diagnosis Top 20

IMPORTANT NOTE:

Selection in Pivot Table:
A) Filters Section
- select “Service Year”

B) Columns Section
- select “Service Type”

C) Rows Section
- select “Diagnosis Code”

D) Values Section
- select “Approved Amount >
Count”

To filter Top 20 diagnosis
1. Copy value of the pivot table
& paste to other column. Cus-
tom sort grand total by larg-
est to smallest. VLOOKUP to
get the diagnosis name.

OVERALL COST BY YEAR IMPORTANT NOTE:

Diagnosis Top 20 (By Employee) Selection In Pivot Table:
A) Filters Section
- select “Service Year” &
“Relationship Group Employ-
ee”

B) Columns Section
- select “Service Type”

C) Rows Section
- select “Diagnosis Code”

D) Values Section
- select “Approved Amount >
Count”

To filter Top 20 diagnosis by
employee.
1. Copy value of the pivot table
& paste to other column. Cus-
tom sort grand total by larg-
est to smallest. VLOOKUP to
get the diagnosis name.

OVERALL COST BY YEAR IMPORTANT NOTE:

Claim Status by Company (Approved vs Rejected) ISMePleOcRtioTnANinTPNivOoTtET:able:
ABa)sFeildteornsthSeecdtaitoangenerated
-onseplievcott “tSaebrlevi,ciensYeeratrt”he pivot
tBa)bCleo, lsuemlencst Section
- select “Service Month” &
“Claim Status”

C) Rows Section
- select “Company Name”
A)
D) Values Section
- select “Approved Amount >
Count”

OVERALL COST BY YEAR IMPORTANT NOTE:

Claim Status by Service Type (Approved vs Rejected) ISMePleOcRtioTnANInTPNivOoTtET:able:
ABa)sFeildteornsthSeecdtaitoangenerated
-onseplievcott “tSaebrlevi,ciensYeeratrt”h&e pivot
Ctaobmlep,asneyleNcatme”
B) Columns Section
- select “Service Month” &
Claim Status”

C) Rows Section
A-)select “Service Type”

D) Values Section
- select “Approved Amount >
Count”

OVERALL COST BY YEAR IMPORTANT NOTE:

Top 20 Claim by Provider ISMePleOcRtioTnANInTPNivOoTtET:able:
ABa)sFeildteornsthSeecdtaitoangenerated
-onseplievcott “tSaebrlevi,ciensYeeratrt”he&pivot
“taCbolme,psaenleycNtame”

B) Rows Section
- select “Provider Name”

C) Values Section
- select “Approved Amount >
AC)ount”
- select “Approved Amount >
Sum”

To filter Top 20 claim by pro-
vider:
1. Copy value of the pivot table
& paste to other column. Cus-
tom sort sum of approved
amount by largest to small-
est.

OVERALL COST BY YEAR IMPORTANT NOTE:

Diagnosis Cost: Top 20 Increment Selection In Pivot Table:
AI)MFPilOteRrTsANSTecNtOioTnE:
-Bsaesleecdto“nSethrveicdeatYaegaern”e&rated
“ConompipvaontytaNbalme e, ”insert the pivot
Bt)aRbolew, sseSleeccttion
- select “Diagnosis Code”

C) Values Section
- select “Approved Amount >
Count”
-As)elect “Approved Amount >
Min”
- select “Approved Amount >
Average”
- select “Approved Amount >
Max”

To filter Top 20 diagnosis cost:
1. Copy value of the pivot table &
paste to other column. Custom
sort sum of increment % by
largest to smallest.

ANOMALIES

ANOMALIES IMPORTANT NOTE:

Dental/Optical/Health Screening Anomalies SIeMlePcOtiRoTnAoNnTpNivOotTEta: ble:
(“-AtCoBt)soanoaeFbsmslpileeeleiptclvd,eeatoscrnot“etsnySltedaeNStcehbraetnvelmecticadte,ielao”in/tYna&soeepgaSrtereitnc”rt,aevhrlie/caehtpeeiTvdayolptthe
screening)

B) Rows Section
- select “Relationship Group” &
“Diagnosis Name”
A)
C) Values Section
- select “Approved Amount >
Count”
- select “Approved Amount >
Sum”

** Please monitor on the treat-
ment cost for any irrelevant
cost/ non-cover treatment/
coverage but approved by TPA.

ANOMALIES IMPORTANT NOTE:

Medical Chit (MC) Trend A) 2X Visit Per Day
IMPORTANT NOTE:
BasedToonfilttheer duatitlaizagteinoenrdaetetadils
on pivboyt Staebrlveic,einDsaetret vthseEmpiv-ot
table,psloeyleecet

B) Public Holiday MC Trend

 To get full public holiday
(PH) leave date.

A)
 To filter MC day according to

service date vs PH date (i.e.
before & after PH date).

** MC days record in PMCare
Medifile only applicable for GP
clinics (depending on clinic sub-
mission data). Therefore, for MC
trend analysis, please read to-
gether with ESS leave record
for more accuracy.