Specifications include, but are not limited to: 4.1.1 Reporting Tool 4.1.1.1 Tool must be template based and standardized across all reporting companies. Tool must be complete and ready for use by October 1, 2023. Tool should be based in Tableau, Microsoft Excel or other similar software. 4.1.1.2 A secondary template must be created to gather additional information as needed. Additional information would be detailed to claim level. 4.1.2 Analysis Tool 4.1.2.1 Create analysis tool to determine statistical outliers and to develop trending patterns per company and by market. 4.1.2.2 Tool must have minimal manual input and must import information from the reporting tool. 4.1.2.3 Tool should be based in Tableau, Microsoft Excel or other similar software. 4.1.3 Data Collection and Storage 4.1.3.1 Collect and store information from insurance companies and the Public Employees Insurance Agency for reporting an analysis from both web forms and potential manual file uploads or batched uploads. Data may include PII or other health information. 4.1.3.2 Data collected will be in aggregate and include, but not be limited to, total authorizations, number denied, and number overturned on denial as per WV State Code 33-15-4s, et.al. 4.1.3.3 The data should be stored in a database such as SQL Server, Oracle, Azure, AWS or similar and backed up routinely. A hot site for disaster recovery is not necessary. 4.1.3.4 All data and created system will be property of the West Virginia Offices of the Insurance Commissioner. Should the contract terminate for any reason, the data and system access must revert to the Offices of the Insurance Commissioner.
