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  #21  
Old 12-19-2017, 10:56 AM
WhosOnFirst WhosOnFirst is offline
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One would have to assume that the upcoming (or, for IBNR, the recent past) months' flu claims will be (or will have been) worse than those included in seasonality factors of the past.

I'm guessing someone up top would direct those in the trenches to add something to claims estimates. Or, simply add it on top after getting the detail-level estimates.

Also, how and when does one eventually release those artificially (though valid) increased reserves? The additional claims will get paid eventually.

It would be a pretty neat study, separating members by whether they received flu shots or not. Question then becomes how do we KNOW they didn't get a flu shot? I mean, I got a shot at work for free. That won't be found in the claims. That would have to be captured somehow. So, what about the other potentially millions of members who don't have a flu shot claim?
My state has a vaccination registry that is updated when I get a flu shot through work. I'm not certain if that information is publicly available.

This is off topic but I've often pondered the idea of integrating EHR data with insurance operations. This is a great example of where an operational benefit might be found. EHR data is updated basically immediately. An insurer could then know about any IBNR claims well before the claim is actually submitted. Heck, with full access to EHRs billing wouldn't even be needed as payment could (theoretically) be derived from the medical record itself.
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  #22  
Old 12-19-2017, 11:45 AM
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LICENSED TO ILL LICENSED TO ILL is offline
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My state has a vaccination registry that is updated when I get a flu shot through work. I'm not certain if that information is publicly available.

This is off topic but I've often pondered the idea of integrating EHR data with insurance operations. This is a great example of where an operational benefit might be found. EHR data is updated basically immediately. An insurer could then know about any IBNR claims well before the claim is actually submitted. Heck, with full access to EHRs billing wouldn't even be needed as payment could (theoretically) be derived from the medical record itself.
Google Flu also tracks flu shots, so there is an outside data source that can be applied to the company population
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  #23  
Old 12-19-2017, 12:15 PM
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Do you know how to do those things in your "instructions"?
How did you learn them (assuming you do know).
I guess I have a basic familiarity with numbers, and I've had extensive conversations with people with many years of IBNR experience. The whole health IBNR process seems kind of goofy. I am very happy at my job so this isn't a cry for help or anything.
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  #24  
Old 12-19-2017, 12:18 PM
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I guess I have a basic familiarity with numbers, and I've had extensive conversations with people with many years of IBNR experience. The whole health IBNR process seems kind of goofy. I am very happy at my job so this isn't a cry for help or anything.
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  #25  
Old 12-19-2017, 12:51 PM
Dr T Non-Fan Dr T Non-Fan is offline
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Yeah, that is probably not the best attitude to have, however much it is true.

It stops being goofy when someone thinks it is the most important thing in the whole company. These are usually finance department people who have a huge (sometimes obsessive) interest in how the accounting (and tax) results are affected by the IBNR estimates.
And, when that someone has enough influence to affect your job security.

So, have fun goofing around!

My advice is simply: be able to defend your estimates with your inputs, and observe the difference in restated IBNR (a look at what your IBNR estimates of a few months ago should have been, now that you have a few months more data) from your reported IBNR, and make changes to your process to lower this difference, if possible.
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  #26  
Old 12-19-2017, 01:33 PM
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I guess I have a basic familiarity with numbers, and I've had extensive conversations with people with many years of IBNR experience. The whole health IBNR process seems kind of goofy. I am very happy at my job so this isn't a cry for help or anything.
Maybe (s)he means the process that company uses, or lack thereof. I know ours (consulting) is pretty ham-fisted. We've had clients say "that's too much" and we change it. Not me, personally.
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