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Upgrade to ProYou are a Network Management Analyst at Anthem. The network strategy team suspects that certain insurance plans have excessive out-of-network (OON) utilization, which drives up costs. They need a plan-level report showing the total approved claims, the split between in-network and out-of-network claims, the OON utilization rate as a percentage, the dollar amount paid for OON claims, and the total paid amount. This "network leakage" report helps prioritize which plans need better provider network development.
You are a Network Management Analyst at Anthem. The network strategy team suspects that certain insurance plans have excessive out-of-network (OON) utilization, which drives up costs. They need a plan-level report showing the total approved claims, the split between in-network and out-of-network claims, the OON utilization rate as a percentage, the dollar amount paid for OON claims, and the total paid amount. This "network leakage" report helps prioritize which plans need better provider network development.