Summit Provides Annual Health Enforcement Training for the U.S. Department of Labor’s Employee Benefits Security Administration

July 27, 2021 Kyle Crane

DOL logo hi-resLast week, Summit Consulting hosted its annual health-enforcement training as part of the learning curriculum at the U.S. Department of Labor (DOL) Employee Benefits Security Administration (EBSA). During this full day of training, we taught the basics of understanding and analyzing health claims data to more than 50 EBSA investigators located across the United States. We hosted this year’s training virtually due to the ongoing pandemic and gave lessons using video conferencing, on-screen presentations, and a demonstration of Summit’s analytical tools.

We opened the training by providing an overview of how we serve our client within EBSA’s Office of Enforcement and assist regional and national health investigators spread out across the country. We taught these investigators about the health-claims life cycle and standard adjudication procedures for major health insurance providers. After completing the more conceptual sessions, we moved into various investigative and statistical techniques to detect health-enforcement issues, including:

  1. Cleaning and preparing data for analysis
  2. Defining the universe of data
  3. Descriptive analytics

Finally, we taught investigators about the various analytical tools we designed and provided full demonstrations on how to use each tool. Some tools identify potential issues and generate statistics on general claims adjudication processes, while others are targeted toward specific health claims statutes, including the Affordable Care Act and the Mental Health Parity and Addiction Equity Act. After concluding the on-screen presentation, students practiced using the tools to gain hands-on experience that will be used in the field. During breakout sessions, Summit offered one-on-one assistance for students seeking additional help. All in all, the training was a big success, and we are already looking forward to next year’s health enforcement training with EBSA!

To read more about Summit’s data analytics work with EBSA, check out our case study.

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