Data Tool
Insurance/Broker Terms
The Software & Output Files
IDs
Sitcoms (literally not data related)
100

This is how many buttons the tool has within the settings page.

What is 12?

100

The amount you pay to simply walk in the door when receiving healthcare.

What is a copay?

100

These are the two main sides to the software. One looks like a paint canvas/speed-o-meter, the other looks like a graph/mountains.

What is Plan Reporting and Claims Details?

100

This ID comes from the vendor source. It typically links eligibility to medical claims.

What is a Unique ID?

100

In this animated sitcom, the main character sometimes says "Dang it, Bobby!"

What is King of the Hill?

200

This key is used by the tool to determine which vendor is being processed.

What is a source key?

200

Another word for a "High Cost Claimant".

What is a shock claimant?

200

You always check this section of the software after loading data

What are import logs? (Also accept auto financials)

200

This ID comes from us, and is formatted as first-last-dob. It typically syncs eligibility to outside PBMs.

What is a member ID?

200

In South Park, Eric Cartman fed Scott Tenorman his own parents, in this delectable dish.

What is a bowl of chili?

300

This setting tells the tool proper column names and expected values. It has the same name as a popular retail store.

What is a TARGET fields?

300

You have to pay this, before your co-insurance kicks in.

What is a deductible?

300

This software tab displays all data SIR loads. You can even show people's names!

What is the Members tab?

300

This important ID is not created in the data.

What is the SIR Master ID?

300

In "The Office", Dwight Schrute owns a successful farm with this crop.

What are beets?

400

This button in the tool, Alex never presses. He just uses Source Fields instead.

What is Edit File Translations?

400

This bare bones basic report, is the bane of our existence. Brokers say we don't match it.

What is an aggregate report?

400

Dental and vision claims are found on this file.

What is a medical claims file?

400

This component of IDs was unreliable. So we switched to first-last-dob instead.

What are person codes? (Also accept SSNs)
400

This sitcom contains this famous quote: "Can I offer you an an egg in this trying time?"

What is It's Always Sunny?

500

This rarely used area in the tool can be used to name an output file, even if the data within the raw file does not have any kind of group name/ID indicator.

What is Substitution Value Patterns?

500

Claims that are incurred before a plan year ends but are paid during [this] period, which is a time after the plan year ends when claims can still be filed.

What are run-out claims?
500

This area in the software can be checked if data is loaded accurately, but still not displaying... (TWO OPTIONS)

Option 1: Account Setup - Enroll - Tiers

Option 2: Plan Reporting - Setup - Enrollment Plan Links

500

This ID is vestigial, and doesn't do anything. (TWO OPTIONS - INCLUDE ID NAME AND FILE NAME)

Option 1: What is the Member ID on the Employee Enrollment File.

Option 2: What is the Employee Dependent Connected Member ID on the Dependent File.

500

This sitcom has an actor who is also in a band called "The Lonely Island".

What is Brooklyn 99?

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