APCD Technical Data Profiles


Additional Resources

As part of CHIA's continuing APCD quality assurance work, a series of payer-specific technical data profiles are available as a resource for APCD data users. Please note: These dashboards do not contain protected health information.

 

Member Eligibility & Medical / Pharmacy Claims Profiling Dashboards

These Excel spreadsheet dashboards evaluate completeness and highlight variances from expected benchmarks for key medical and pharmacy claims fields after being merged with member eligibility files. The dashboards display total and per member per month metrics for key medical and pharmacy claim financial fields for incurred dates of service from July 1, 2014 through June 30, 2015.

 


CarrierMember Eligibility & Medical Claims DashboardMember Eligibility & Pharmacy Claims Dashboard

Anthem

Link to data
Note:
Pharmacy claims not profiled

BCBSMA

Link to data
Link to data

BMC Healthnet

Link to data
Link to data

Celticare

Link to data
Link to data

Fallon Health and Life Assurance Company (FHLAC)

Link to data
Link to data

Fallon Community Health Plan (FHCP)

Link to data
Link to data

Harvard Pilgrim Health Care (HPHC)

Link to data
Link to data

Health New England (HNE)

Link to data
Link to data

Minuteman

Link to data
Link to data

Neighborhood Health Plan

Link to data
Link to data

Tufts

Link to data
Link to data

Tufts Health Public Plans

(formerly Network Health)

Link to data
Link to data

Download All Dashboards
(Zip File)

Link to zip file of all data
Link to zip file of all data