Two types of reporting tools are available to insurance carriers who offer TELUS Health Solutions Pay-Direct and Deferred Payment electronic claims processing: Online Reporting and Interactive Reporting. The information contained in these reports may assist carriers in the underwriting and analysis of claims data for their groups.

Online Reporting

Our sophisticated web-enabled reporting tools provide over twenty online reports, such as segment claims statistics by therapeutic class, pharmacy location and other significant categories. Our statistical reports protect the privacy of individuals while providing valuable information on trends and patterns of activity.

List of standard reports available:

• Claims summary reports
• Summary of claims paid by third parties
• Summary of rejected claims
• Detailed rejected claims reports DIN not covered
• Claims frequency by monthly use and relationship codes
• Claims by age categories
• Claims by dollar value
• Totals and averages by division/unit
• Drug category reports
• Disease category reports
• Life-enhancing drug reports
• Life-enhancing drug detailed reports
• Top 50 DINs claimed by frequency and amount paid
• Pharmacy utilization reports
• Detailed pharmacy utilization reports
• Detailed claims paid by exception reports
• Health Assure Claims DUR reports
• Geographical breakdown of claims paid
• Deferred drug claims reports
• Trial drug program reports
• Maintenance drug program reports
• Prior authorization program reports

Interactive Reporting

The Assure Claims Drug Interactive reporting module provides important, current information on the performance of prescription drug plans. This package is invaluable for users seeking to compare the specific results of one group against the TELUS Health Solutions Book of Business, or against other comparable groups in the same industry sector. This system incorporates a variety of tools to analyze the diverse factors affecting the cost of a drug benefit plan. Carriers and Benefit Advisors can use our Interactive Reporting to extract information in summary form. They can then reformat and analyze the data based on demographic variables including age categories, geography, plan type and industry type. Data is updated monthly.

Four different types of reports are available to compare the results of one specific group against the results of other groups:

Assure Claims Drug Care Reports - identify the prevalence of diseases affecting a group client based on the frequency and cost of the drugs claimed.

Assure Claims Drug PBM Workbench - identifies and quantifies key factors influencing the cost of a prescription drug plan, such as age, geography, industry type as well as plan design.

Assure Claims Drug Pharmacy Reports - identify the frequency and distribution cost of a drug benefit plan by pharmacy chain, drug source (brand, generic and single source with no generic available) as well as professional and other fees.

Assure Claims Drug Service Monitor - summarizes service and administrative issues that affect a drug benefit program

Privacy Policy

As a service provider, TELUS Health Solutions relies on its insurance-carrier clients to (i) ensure that the insurance carriers customers and claimants are aware of the intended use and disclosure of their personal information; (ii) obtain the consents required by applicable law for the use and/or disclosure of such personal information by TELUS Health Solutions and its sub-contractors, in relation to the services to be rendered to the insurance carriers.

Personal information of claimants is to be used and/or disclosed by TELUS Health Solution only for the provision of services contracted by the insurance carrier. All reports prepared for our insurance-carrier client are the property of our contracted insurance-carrier clients. Any dissemination of the reports containing personal information is the responsibility of each insurance carrier clients.