Open claims data is obtained from clearing houses and switches, therefore it does not guarantee that all claims for a patient are captured. Open claims represent some, and possibly all, claims for a specific patient.
Supported by retail and specialty pharmacy claims for a comprehensive patient landscape
Medical Claims are obtained via a patient’s medical insurance. Each claim contains ICD10 diagnosis codes and HCP information from procedures, visits and items billed in a clincal setting, such as hospital, outpatient center or doctor's office.
Retail Pharmacy claims are obtained via a patient’s pharmacy insurance. These claims are for medicines that are prescribed by an HCP and picked up at a pharmacy location.
Specialty Pharmacy claims are obtained via a patient’s pharmacy insurance. These claims are dispensed by companies called Specialty Pharmacies. As the name implies, they dispense medicines that have a high dollar value and are less common. These medicines are typically mailed directly to the patient.