Once payer-submitted data has successfully passed the extensive initial validation and quality tests performed by CIVHC and data manager Human Services Research Institute (HSRI) and NORC at the University of Chicago, the data are ready to be ingested into the warehouse.
Previous queries have detailed the process for the monthly submission and intake of claims data to the Colorado All Payer Claims Database (CO APCD). This query explores what happens to the data after it is accepted into the warehouse.
CO APCD Specific Processing
Once the data makes it into the warehouse, additional processing steps are performed to increase the functionality and utility of the CO APCD. Each step includes its own data quality checks to eliminate errors and ensure continued high-quality output of CO APCD data. These steps include:
- Adding “value-add fields” or tagging the data, which makes performing analyses more efficient. For example, flagging freestanding emergency departments or claims by type (medical, pharmacy, or dental).
- Addition of classification, such as Colorado Division of Insurance (DOI) regions.
- Application of third-party tools such as data groupers or drug reference files.
Continued Quality Assessments
At the time of ingestion into the warehouse, the data has already cleared numerous checks to ensure the quality of each set of submissions. The third stage of post-ingestion data quality checks focuses on assessing the completeness and the overall health of the database rather than a specific batch of submissions.
In this final stage, the latest data is compared to historic benchmarks like volume of submissions by claim type, monthly payments by member, eligibility file volume, and other key measures to make sure they compare reasonably with expected amounts. Significant gaps or anomalies may indicate an error in data submission or processing that needs to be addressed before final production and release.
As part of this process, two important indices are also reviewed:
- Master Patient Index – An internal, de-identified list of people with health coverage in Colorado
- Master Provider Dictionary – A complete list of providers in Colorado and their unique identifier
These indices function as a benchmark “control group” of people and providers in the CO APCD, allowing CIVHC to compare the data with the current version of the data warehouse. Through cross-comparison of the database with these master lists, CIVHC analysts can identify where there may be existing gaps that may need resolution or re-submission by a payer or group of payers.
Processes for in-warehouse quality checks and processing steps are regularly reviewed and re-visited by CIVHC and data warehouse managers to ensure the process remains as comprehensive, effective, and efficient as possible.
