The document outlines an agenda for a business analysis training program focused on healthcare domains. The training will cover topics such as introduction to business analysis, requirements gathering, software development lifecycles, healthcare insurance concepts, health insurance claims processing, EDI transactions, and healthcare regulations. The agenda is intended to equip participants with skills in business analysis as applied to healthcare systems and processes. Contact information is provided for the training organization.
2. Introduction to Business Analysis
System Development Life Cycle (SDLC)
Software Engineering Methods - SDLC
Requirement Analysis Process
BA Templates
Requirement Elicitation
Business Requirement Gathering Tools
Use Cases
UML Methodology
Business Analysis & Modeling Tool
Data Modeling & Techniques
QA/Software Testing Overview
SQL Overview
Health Insurance Overview
Health Insurance Claims
Health Insurance Sub-Systems
Health Insurance Transactions and Codes
EDI Transactions-I
EDI Transactions-II
Overview of Claim Adjudication Tools and
Government Mandates
AGENDA
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3. Introduction to Business Analysis
Introduction to Business Analysis
Roles and Responsibilities of a Business Analyst
Project Team
Importance of a Business Analyst in the Project Team
BA Deliverables
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Mail Id : info@Vibloo.com
Skype Id : info.vibloo
US: +1-248-436-8449
IND: +91-40-3296-5222
4. System Development Life Cycle (SDLC)
Introduction to Business Analysis
Roles and Responsibilities of a Business Analyst
Project Team
Importance of a Business Analyst in the Project Team
BA Deliverables
Mail Id : info@Vibloo.com
www.vibloo.com/Business-Analysis-with-Health-Care
Skype Id : info.vibloo
US: +1-248-436-8449
IND: +91-40-3296-5222
5. Software Engineering Methods- SDLC
Waterfall Method
Rational Unified Process (RUP)
AGILE Methodology
Spiral Model
V-shaped Model
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www.vibloo.com/Business-Analysis-with-Health-Care
Skype Id : info.vibloo
US: +1-248-436-8449
IND: +91-40-3296-5222
6. Requirement Analysis Process
What are requirements
Requirement Gathering Techniques
Creating Business Requirement Document
Requirement Traceability Matrix (RTM)
GAP Analysis
Impact Analysis
JAD sessions
Mail Id : info@Vibloo.com
www.vibloo.com/Business-Analysis-with-Health-Care
Skype Id : info.vibloo
US: +1-248-436-8449
IND: +91-40-3296-5222
7. BA Templates
Business Case Document
Statement of Work
Project Charter
Meeting Agenda
Meeting Minutes
Business Requirement Document (BRD)
Functional Requirement Document (FRD)
Change Request process document
RTM
Mail Id : info@Vibloo.com
www.vibloo.com/Business-Analysis-with-Health-Care
Skype Id : info.vibloo
US: +1-248-436-8449
IND: +91-40-3296-5222
8. Requirement Elicitation
Requirements Discovery Sessions
Specifying the Activities
Using Use Case Modeling
Using Data Flow Diagramming
Prototyping (Storyboarding, Navigation Flow, Paper prototyping, Screen flows)
Discovering the Information Requirements
Mail Id : info@Vibloo.com
www.vibloo.com/Business-Analysis-with-Health-Care
Skype Id : info.vibloo
US: +1-248-436-8449
IND: +91-40-3296-5222
9. Business Requirement Gathering Tools
Rational Requisite Pro
Caliber RM
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Skype Id : info.vibloo
US: +1-248-436-8449
IND: +91-40-3296-5222
10. Use Cases
Understanding Use Cases
Use Case Relationships
Extended Relationships
Creating Use cases from Requirements
Creating Use case narratives
Change Management & Version Control Concept
Mail Id : info@Vibloo.com
www.vibloo.com/Business-Analysis-with-Health-Care
Skype Id : info.vibloo
US: +1-248-436-8449
IND: +91-40-3296-5222
11. UML Methodology
What is UML?
Use Case Diagrams
Activity Diagrams
Sequence Diagrams
UML Diagrams
Mail Id : info@Vibloo.com
www.vibloo.com/Business-Analysis-with-Health-Care
Skype Id : info.vibloo
US: +1-248-436-8449
IND: +91-40-3296-5222
12. Business Analysis & Modeling Tool
MS Visio
Rational Rose
Mail Id : info@Vibloo.com
www.vibloo.com/Business-Analysis-with-Health-Care
Skype Id : info.vibloo
US: +1-248-436-8449
IND: +91-40-3296-5222
13. Data Modeling & Techniques
Data Dictionary and Glossary
Data Flow Diagrams
Data Modeling
Mail Id : info@Vibloo.com
www.vibloo.com/Business-Analysis-with-Health-Care
Skype Id : info.vibloo
US: +1-248-436-8449
IND: +91-40-3296-5222
14. QA/Software Testing Overview
Introduction to QA Methodology
Role of BA in Testing
Creating Test Plans
Creating Test Cases
Creating Test Results
GUI and Unit Testing
System Testing
User Acceptance Testing
Production Testing
Mail Id : info@Vibloo.com
www.vibloo.com/Business-Analysis-with-Health-Care
Skype Id : info.vibloo
US: +1-248-436-8449
IND: +91-40-3296-5222
15. SQL Overview
Introduction to SQL
Basic SQL queries
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www.vibloo.com/Business-Analysis-with-Health-Care
Skype Id : info.vibloo
US: +1-248-436-8449
IND: +91-40-3296-5222
16. Health Insurance Overview
What is Health Insurance?
Why Do We Need Health Insurance?
Health Insurance Coverages
Healthcare Hierarchy
Major Health Insurance Companies
Health Insurance Terminologies
Types of Health Insurance Plans
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Types of Managed Care Plans: HMO, PPO, POS
Key Players in Healthcare
Types of Providers
In Network vs Out of Network Providers
Medicaid
Medicare
Healthcare Glossary
17. Health Insurance Claims
HIPAA
Protected Health Information (PHI)
What is Health Insurance Claims?
Claims Invoice Types
Mode of Claims Submission
Sample X12
Sample XML
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Sample IRL
Claim Adjudication Process
EDI Transaction Sets Used in Various Industries
HIPAA Transaction Sets
X12 Envelope Structure
X12 Loops and Segments
18. Health Insurance Sub-Systems
Member
Provider
Claims
Prior Authorization
Third Party Liability (TPL)
References (All type of Codes)
Contracts Management (Managed Care)
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Skype Id : info.vibloo
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IND: +91-40-3296-5222
19. Health Insurance Transactions and Codes
HIPAA Standards- 4010 vs 5010
Implementation Guide vs Technical Report Type 3 (TR3)
Type of Codes Used in Health Insurance
ICD-9 vs ICD-10 Coding System
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20. EDI Transactions-I
837 EDI Claims; 835 Remittance
Edits and Validations
Reports and Acknowledgements
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Skype Id : info.vibloo
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21. EDI Transactions-II
Other EDI 5010 Transactions
DRG, CPT, HCPCS
Mail Id : info@Vibloo.com
www.vibloo.com/Business-Analysis-with-Health-Care
Skype Id : info.vibloo
US: +1-248-436-8449
IND: +91-40-3296-5222
22. Overview of Claim Adjudication Tools &
Government Mandates
MMIS & Facets
National Healthcare Reform
Affordable Care Act / Govt Reforms
Electronic Medical Records
Healthcare Exchange
Review Templates/Sample Artifacts
Other Mandates and projects
Mail Id : info@Vibloo.com
www.vibloo.com/Business-Analysis-with-Health-Care
Skype Id : info.vibloo
US: +1-248-436-8449
IND: +91-40-3296-5222