User blog: George G

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by George G - Thursday, January 28, 2016, 8:04 AM
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Facets Benefit Configuration application help  in creating and maintaining healthcare products like HMO,PPO etc in Facets. Facets is a robust application supporting the payers  to create product class which can be used again and again as a blue print for new products. Using these applications, creating new products become very simple which can be customized to meet business requirements.

Benefit Configuration is a multiphase process to allow the setup of different line of business,payment process for the service,covered ,uncovered services etc.System have several per-defined values to choose from which  helps the configuration analyst during the end to end setup process.

[ Modified: Monday, October 24, 2016, 9:02 AM ]
 
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by George G - Thursday, January 28, 2016, 8:03 AM
Anyone in the world

Facets Billing module leads the entire billing process; by defines billing occurrence, day to bill,  premium invoice reconciliation, and lead period. It also allows the Facets reporting system to produce different statements and reports from this data. Fees, discounts and other optional and mandatory attributes are also processed. Premium calculations are performed in the Subscriber/Member and Plan application sub system. Notes are attached to the invoices, and tables are created to supply directly to the reporting sub system. All the details are summarized to the billing entity level. If any payments are  suspended, they are applied to the bill.

Some of the key features supported by the billing application group:

  1. Managing Fees
  2. Managing and applying discounts
  3. Handling payment adjustments
  4. Performing and managing Self-Billing
  5. Managing Medicare Member Billing
  6. Processing Receipts
  7. Premium Reconciliation

 

[ Modified: Wednesday, May 18, 2016, 9:16 AM ]
 
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by George G - Thursday, January 28, 2016, 8:02 AM
Anyone in the world

SAP is one of the largest software firms in the world today. It strives to provide businesses with technological solutions needed for daily business operations. Technology is undeniably an integral part of today’s business. On one hand, business owners require technology to run their operations faster and more efficiently. Customers, on the other hand, rely on technology for shopping. It’s for this reason that companies such as SAP have continued to evolve.

What Is SAP?
SAP stands for System, Applications and Products. The company strives to develop systems and programs that can provide business owners with solutions to problems they face when carrying out their business operations. Apart from helping business owners, SAP has also created numerous employment opportunities. For instance, many technology specialists today are trying hard to become SAP consultants. However, for you to become a SAP consultant there are certain essential prerequisites you need to fulfill.
Becoming a SAP Consultant
For starters, outline the reasons why you wish to serve as a SAP consultant. Some people want to be associated with SAP because it is the leading software firm in the world. Others are looking for a chance to make a quick buck. Whatever the reason you have for embarking on this venture, make sure you have a clear understanding of what the job entails. There are several types of SAP consultants. Each of them serves a specific purpose. It’s critical to understand these aspects before you venture into the business.
Categories of SAP Consultants
• SAP Developer Consultants: They are charged with the responsibility of coding ABAP or JAVA programs.
• SAP Basis Consultants: They install, service, and tune SAP servers and files.
• SAP business/sales consultants: They are charged with selling SAP to customers.
• SAP Functional Consultants: They customize SAP according to customer preferences.
For you to fit in any of these categories, you need to have the necessary skills. However, some of these skills will vary with the amount of experience you have. These are some of the most important skills that virtually all SAP employers seek.
• Good communication skills: As a professional consultant, you need to be articulate and convincing in every way possible. You have to be good at breaking down technical information.
• Extensive SAP knowledge of specific module
• Good knowledge of banking, telecommunication, and other domain requirements
• A good team player and a problem solver
A good academic background is needed for any kind of SAP consultant position. Most employers prefer a SAP consultant who has completed at least a degree course such as B.E or BSc. You also need a valid SAP certificate from an approved SAP training associate. SAP training can prove to be an expensive venture although it’s a worthy undertaking. After your SAP consultant course, consider joining an authorized IT consultancy firm such as Deloitte or IBM as a trainee. This will give you the needed exposure and experience to work as a professional SAP consultant. A career in the SAP consulting industry can be rewarding if you have enough experience.

 

 
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by George G - Thursday, January 28, 2016, 7:59 AM
Anyone in the world

Total 200 questions will be on your exam selected from a bank over 13000 questions that will be Situational Questions, Questions with two or more right answers, Questions with extraneous information, Sometimes you never heard of, Correct Answer to a different question, A new approach to a known topic, Double negative, Questions where understanding is important and off course Questions with new approach to known topic. It will be a complete mixer of hard and easy questions. you have to answer in 4 hours. So, 50 questions per hour. That simple! Most people find four hours to be more than sufficient for the exam.

 

Most of the Computer based exam conducted in Prometric centers. But don’t worry. Exam is preceded by a 15-minute computer tutorial on the format of the exam. Each question has exactly one correct answer. Out of these 200 questions, 25 questions are research questions. These are randomly placed throughout the exam. These questions are not evaluated while computing exam results. You will only be evaluated on the basis of 175 questions.

On clicking the final submission button, the system will compute the results immediately and provide you with the Pass or Fail message. To pass the PMP examination, you must answer a roughly a minimum of 106 of the 175 scored questions correctly. Immediately on completion of the exam, the Prometric center will give you the provisional mark-sheet. The mark-sheet will give the breakup of the score by Process Area.

There is no negative marking in the exam. Unanswered questions are treated as wrong questions. Examination

Scores are confidential. As of this writing there is no definitive passing score for the exam – for each of the sections in last page will be graded either a) Proficient b) Moderately Proficient c) Below Proficient

 
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by George G - Thursday, January 28, 2016, 7:58 AM
Anyone in the world

Managing Project , Program & Portfolio a important concept to understand the areas of Project, Program & Portfolio management.

About scope: Project has defined objectives and Scope is progressively elaborated. Programs have larger scope and provide more significant benefits and portfolio has business scope that changes with strategic goals of organization.

For changes, Project Managers expect change and implement processes to keep change managed whereas Program Manager must expect change from both inside and outside the program. Portfolio managers continually monitor changes in the broad environment.

In case of planning, Project Managers progressively elaborate high level information into detailed plans throughout the project life cycle. Program Managers develop the overall program plan and create high-level plans to guide detailed planning at the component level. Portfolio Managers create and maintain necessary processes &communication relative to the aggregate portfolio.

 

 

 
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by George G - Thursday, January 28, 2016, 7:50 AM
Anyone in the world

Facets (Trizetto Claims processing system)provides several functionality which is supported under the application group or you can call modules.It helps the organizations to perform their day to day operational work  by utilizing any or all of the application groups.

Facets is a registered trademark of  Trizetto.Facets is a client/server based system ,developed in JAVA technology and all the business rules are running behind the scene as a core functionality.It allows the industry users to be in compliant with all the latest mandates and legislation as long as the latest version of the solution is in place by the Facets users.

Facets implementation allows the integration with many 3rd party applications and the most common one is the claims Xten or TPS (Total Payment system). This type of integrations help the organizations to reduce cost and gain high value from the cost saving prospective.

Facets have two sides of the jobs in the market which are very demanding.One hand there are less skilled resource available ,but  industry needs more resources to fulfill all the federal/state mandates.

Most demanding positions are:

  • Facets Business Analyst
  • Facets System Analyst
  • Facets Quality Analyst
  • Facets Developer
  • Facets System Administrator

Facets system analyst is responsible to setup the parameters required to configure the product.

Facets key Feature:

  • Best suited solution of the healthcare management
  • Very demanding for handling managed care products
  • Very robust and user friendly user interface
  • Allow great security level with the user roles and access level management

All the application groups are as follows:-

  • Accounting
  • Accumulator
  • Application support
  • Benefit Configuration
  • Billing
  • Hippa Privacy
  • Capitation
  • Claims Process
  • Claims processing-ITS
  • Commission
  • Criteria
  • Customer Service
  • Dental Plans
  • Dental provider agreement
  • FSA Plan
  • ITS Application Support
  • ITS Plan
  • Medical Plan
  • Provider NetworkX
  • Provider aggreement
  • Pricing Profile
  • Provider
  • Subscriber
  • Utilization Management
  • Workflow Configuration

Note :Each of the Application group is further subdivided into several functionality.

You can contact our training department for any training need.

 

[ Modified: Monday, October 24, 2016, 9:03 AM ]
 
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by George G - Thursday, January 28, 2016, 7:46 AM
Anyone in the world

In any project Business Analyst supports the project manager in identifying a risk.Risk can be identified by analysis,elicitation or by reviewing the organizational assets like lesson learned from the historical similar project.

There are several types of risks which can be identified for the Program,Project,Product or the process which can include:

  • Time: This could be a risk that the time slot allocated for the project is not sufficient to achieve the development outcome.
  • Resource:This is an another type of risk where project is running out of option due to the resource constraint.
  • Business Expertise:This is one of the area which becomes a major risk for the project where team is missing a key subject matter expert, who can provide or assist the team with subject knowledge.
  • Stakeholder limited access:In many instance if the project is restricted to approach stakeholders for a limited time but project require more of the time from stakeholder then unavailability can become a major risk for the project.
  • Validation & Verification:If the requirements are not validated and verified formally then it gives the room for mistakes and assumptions.This can be one of a major risk.

These are some of the key risk factors but there are many more.

 

 

 
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by George G - Thursday, January 28, 2016, 7:44 AM
Anyone in the world

According to ITIL classification risk types can be defined as follows:-

  • Operational Risk
  • Design Risk
  • Contract Risk
  • Market Risk

 

Operational Risk could be the result of the operation problems identified during the regular business processing.

Design risk could be just the outcome the poor design which is deviated from the overall goal.

Contract risk is the problem with the service provider who will make it impossible for the organization to fulfill its service level obligation with its  client.

Market risk  is that where the product or service will not meet the demand of the market.

 

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[ Modified: Thursday, January 28, 2016, 7:44 AM ]
 
Picture of George G
by George G - Thursday, January 28, 2016, 7:43 AM
Anyone in the world

According to ITIL classification risk types can be defined as follows:-

  • Operational Risk
  • Design Risk
  • Contract Risk
  • Market Risk

Operational Risk could be the result of the operation problems identified during the regular business processing.

Design risk could be just the outcome the poor design which is deviated from the overall goal.

Contract risk is the problem with the service provider who will make it impossible for the organization to fulfill its service level obligation with its  client.

Market risk  is that where the product or service will not meet the demand of the market.

 

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by George G - Thursday, January 28, 2016, 7:42 AM
Anyone in the world

Risk Analyst Should know:

Before we start talking about the risk management strategy ,it is important for business analyst to be aware of these risks like

  • Skills and expertize-It is a risk of not getting the resources with the required expertise for project.
  • Quality is a risk and can be very dangerous if the product does not meet the quality measures.
  • Technological issues can be very risky for any project.
  • Project termination or closure due to any xyz reason can become a risk for the operation team.
  • Security is considered a very big risk at this point of time where we are dealing in the era of electronic data. Vulnerability to an attack result in danger or loss.

Risk Management Strategy:

If there is a risk then it is crucial to have the plan for managing that risk.

As art of your plan you can consider:

  • Avoiding the risk by putting preventive actions in place. To do that you may want to explore alternative options to achieve your goal.
  • Transfer the risk responsibility to the more appropriate party for dealing with the risk .
  • Accepting the risk. By doing this you have to put together the plan to handle the risk by any ways.
  • Mitigate the risk. You can only do this when you can plan for the action which may reduce the impact of the risk. You can have a plan which is proactive or may be retro-active.
[ Modified: Monday, July 31, 2017, 8:46 AM ]
 
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