Sophorn Reporting Systems

The Key to Enrollment/Billing Data Analyst

SOLUTIONS FOR YOUR ENROLLMENT & BILLING MANAGEMENT GOALS

A complementary products which extends claim Management’s analytical power by delivering tightly integrated reporting against the results of Membership and Billing records in the AMISYS.

SIMPLIFYING COMPLEX DATABASES

As you pick items in the Sophorn Reporting Systems to create a Provider’s Panel report, it appears as a clear and concise English sentence- so it’s easy to select what will be retrieved.

The following are the samples of the Sophorn Reporting Systems Menu:

These reports are running from the AMISYS Run screen MM0300 for seamless integration with other custom applications written in PowerHouse, Cobol, etc.

MODE:F ACTION: Command Menu MM0300 02/08/00

OP#:NUON A.009.01 09:27

01 Command: 15

02 NBSpool Information/RunNBSpool 03 CONSUMER DENTAL CARE INTERFACE

04 Cycle Group Report 05 Rates and Benefit Plan Report

06 Outpatient Auth. Entered Rpt 07 REFLECTION FILE TRANSFER

08 CLAIMS/VOIDED CHECK REPORT 09 Student Status Report

10 Display all User Sessions 11 VSP Membership Extract

12 Provider's Panel Report 13 Overages Dependents Report

14 Download Provider file/PC 15 Enrollment/Billing Report

16 Display/View Output to Screen 17 Membership Card Extract

18 Inpatient Admission Sort by RP 19 Interest Payable Error Report

20 Missing Billing Cycle Report 21 Pended Claim by Operator #

Enter the Id# of the command to run, or hit return.

MENU200

*** MENU200.REPORTS ***

*** Enrollment/Billing Reports ***

Custom Reports

1 - Cycle Group Report

2 - Provider’s Panel Report

3 - Rate & Benefit Plan Report

4 - Student Status Report

5 - Overages Dependents Report

6 - Missing Billing Cycle Reprot

7 - Group Renewal Date Report

8 - Suspend Group Report

9 - Membership Report by Group#

Please enter the option number(1-9) of Report

>1

Enter the BEGINNING Date range for extract (CCYYMMDD)

>19991101

Defaul the ENDING Date range for extract (SYSDATE)

Enter OP# for extract

>NUONSO

Do you wish to list MENU200? N

Do you wish to stream MENU200 now? Y

#J548

Press RETURN to continue.

Report sample:

===============================================================================

Feb 08, 2000 9:15 CYCLE GROUP REPORT Page 1

GROUP# NAME PAID THRU CYCLE CARRIER C. G.

BATEST BENEFIT TEST GROUP 0 HM MD 1

HMOTST HMO BENEFIT TEST 0 HM MD 1

010101 PRICING TEST 0 01 HM DC 1

100101 TUCKER, FLYER, & LEWIS 19991130 01 HM DC 1

100110 THE ELLERBE BECKET COMPA 0 01 HM DC 1

100113 GPS MOBILE INC. 19981130 01 HM DC 1

100120 U S ASIA COMMERCIAL 19990831 01 HM DC 1

100261 REINCARNATIONS 19990930 01 HM DC 1

100365 STATE PLAZA HOTEL 0 01 HM DC 1

100408 THE DONOHOE COMPANIES 19991031 01 HM DC 1

100727 COHEN, PRAME & GOLDBERG 19990228 01 HM DC 1

100742 CASUAL IMAGE, INC. 19990531 01 HM DC 1

100772 DECKELBAUM, OGENS AND 0 01 HM DC 1

100781 FED EMP HEALTH BENIFIT P 0 01 HM DC 1

100788 ADWORKS, INC. 0 01 HM DC 1

Continue?

Example 2:

*** MENU200.REPORTS ***

*** Enrollment/Billing Reports ***

Custom Reports

1 - Cycle Group Report

2 - Provider’s Panel Report

3 - Rate & Benefit Plan Report

4 - Student Status Report

5 - Overages Dependents Report

6 - Missing Billing Cycle Reprot

7 - Group Renewal Date Report

8 - Suspend Group Report

9 - Membership Report by Group#

Please enter the option number(1-9) of Report

>2

Enter the BEGINNING Date range for extract (CCYYMMDD)

>19991201

Defaul the ENDING Date range for extract (SYSDATE)

Enter OP# for extract

>NUONSO

Do you wish to list MENU200? N

Do you wish to stream MENU200 now? Y

#J551

Press RETURN to continue.

Report sample:

################################################################################

# #

# #

# SOPHORN tm #

# CENTREVILLE HEALTH, INC. #

# #

# MEMBER ELIGIBILITY BY PROVIDER AFFILIATION #

# #

# PANELB-01 #

# 02/08/00 #

# #

# SELECTION CRITERIA: #

# #

# AS OF DATE: 11/30/1999 #

# AFFILIATION: ALL #

# BUSINESS UNIT: IN #

# PROGRAM#: CO #

# REGION: ALL #

# SUB PROGRAM: ALL #

# RISK POP: ALL #

# TPA CORP/GROUP/DIV: #

# #

# SORT ORDER: #

# #

# BUSINESS SEGMENT #

# AFFILIATION #

# MEMBER NAME #

# #

# *** PANELRPT VERSION A.001.01 06/24/98 #

# #

# #

################################################################################

PANELRP-01 1.01 06 CENTREVILLE HEALTH, INC. PAGE: 1

02/08/00 9:42 AM MEMBER ELIGIBILITY BY PROVIDER AFFILIATION

AS OF DATE: 11/30/1999

BUS. SEG.: INCO

PROVIDER NAME: SHRIHARSH POKE

AFFILIATION#: 1000

ADDRESS: XXXX MERWOOD HALL LANE

SUITE 404

ALEXANDRIA, VA 22306

USA

NEW

NAME ADDED* MEMBER# COPAY EFFECTIVE CANCELLED BIRTH SEX AGE PACKAGE

====================================================================================================================================

DAVID, JOHN M XXXXXXXXX01 $10 06/01/1997 / / 07/25/1958 M 41 OE

ADDRESS: XXXX HUNTINGTON AVE ALEXANDRIA, VA 22303 . . ........

PARKS, SMITHS N XXXXXXXX201 04/01/1999 / / 09/26/1958 M 41 KC

ADDRESS: XXXX DESOTO COURT WOODBRIDGE, VA 22193 703.730.2470........

SARVER, MAN B XXXXXXXX801 04/01/1999 / / 09/14/1947 M 52 KC

ADDRESS: XXXX QUANDER RD ALEXANDRIA, VA 22307 703.765.2465........

TOTAL FOR THIS AFFILIATION: 3

PANELRP-01 1.01 06 CENTREVILLE HEALTH, INC. PAGE: 2

02/08/00 9:42 AM MEMBER ELIGIBILITY BY PROVIDER AFFILIATION

AS OF DATE: 11/30/1999

BUS. SEG.: INCO

PROVIDER NAME: THEODORE WELLS-GREEN

AFFILIATION#: 1004

ADDRESS: 845B QUINCE ORCHARD BLVD

GAITHERSBURG, MD 20878

USA

NEW

NAME ADDED* MEMBER# COPAY EFFECTIVE CANCELLED BIRTH SEX AGE PACKAGE

====================================================================================================================================

COFFEY, KONG XXXXXXXX304 $10 02/01/1999 / / 06/26/1993 F 6 CB

ADDRESS: XXXXX WEST BOURUE GAITHERSBURG, MD 20878 301.519.0084........

COFFEY, KING XXXXXXXXX05 $10 02/01/1999 / / 11/16/1994 F 5 CB

ADDRESS: XXXXX WEST BOURUE GAITHERSBURG, MD 20878 301.519.0084........

GIBSON, ERK XXXXXXXXX02 $10 06/01/1999 / / 01/06/1994 M 5 JA

ADDRESS: XXX CLOPPER RD. GAITHERSBURG, MD 20878 301.987.7036........

GIBSON, DARRYL XXXXXXXXX03 $10 06/01/1999 / / 03/15/1997 M 2 JA

ADDRESS: XXX CLOPPER RD. GAITHERSBURG, MD 20878 301.987.7036........

HOWARD, SAMAN XXXXXXXXX03 01/01/1999 / / 04/11/1994 F 5 OL

ADDRESS: XXXXX FERTILE MEADOW GAITHERSBURG, MD 20877 301.216.0393........

HOWARD, JOHN XXXXXXXXX04 01/01/1999 / / 03/08/1997 M 2 OL

ADDRESS: XXXXX FERTILE MEADOW GAITHERSBURG, MD 20877 301.216.0393........

HOWARD, JOHN XXXXXXXXX05 01/01/1999 / / 09/17/1998 M 1 OL

ADDRESS: XXXXX FERTILE MEADOW GAITHERSBURG, MD 20877 301.216.0393........

MATHIS, JOHN R XXXXXXXXX03 $10 11/01/1998 / / 12/30/1994 F 4 JA

ADDRESS: XX PIKERING CT. #1 GERMANTOWN, MD 20874 301.515.1659........

TAPPARO, JOHN XXXXXXXXX03 $10 09/27/1999 / / 11/15/1996 F 3 OE

ADDRESS: XXXXX MAPLE CREST POTOMAC, MD 20854 301.217.0405........

TOTAL FOR THIS AFFILIATION: 9

Continue?

Sample Report 3:

CENTREVILLE HEALTH, INC.

RUN NAME: BAR160X-02 PREMIUM RATES REPORT (RATE ACTIVITY) PAGE: 1

RUN DATE: 02/08/00 MODIFIED BETWEEN: 01/01/1997 AND: 02/08/2000

BUS.SEGMENT: IN CO HM

DIVISION#/GROUP#: 1001000001 NAME: ALEXANDRIA PACKAGING

=================

BP DV/GP TR CY

.. LB .. .. .. .. 1001000001 .. .. 4T SC .. .. .. .. ..

RIDER PREMIUMS MOD.DATE

VGOLD5 314.340 .000 .000 05/05/1998 WALL

VGOLD5 330.810 .000 .000 08/10/1998 GIFF

BP DV/GP TR CY

.. LB .. .. .. .. 1001000001 .. .. 4T SF .. .. .. .. ..

RIDER PREMIUMS MOD.DATE

VGOLD5 499.640 .000 .000 05/05/1998 WALL

VGOLD5 518.850 .000 .000 08/10/1998 GIFF

BP DV/GP TR CY

.. LB .. .. .. .. 1001000001 .. .. 4T SO .. .. .. .. ..

RIDER PREMIUMS MOD.DATE

VGOLD5 165.450 .000 .000 05/05/1998 WALL

VGOLD5 174.110 .000 .000 08/10/1998 GIFF

BP DV/GP TR CY

.. LB .. .. .. .. 1001000001 .. .. 4T SS .. .. .. .. ..

RIDER PREMIUMS MOD.DATE

VGOLD5 344.110 .000 .000 05/05/1998 WALL

VGOLD5 417.860 .000 .000 08/10/1998 GIFF

DIVISION#/GROUP#: 100100CBRA NAME: ALEXANDRIA PACKAGING

=================

BP DV/GP TR CY

.. LB .. .. .. .. 100100CBRA .. .. 4T SC .. .. .. .. ..

RIDER PREMIUMS MOD.DATE

VGOLD5 314.340 .000 .000 05/06/1998 WOOD

VGOLD5 330.810 .000 .000 08/10/1998 GIFF

Sample 4:

GRR1900-01 A.001.01 CENTREVILLE HEALTH, COMMUNITY HEALTH PLAN, INC. PAGE: 1

02/08/00 10:47 AM STUDENTS AGE 19 OR OLDER

EFFECTIVE BETWEEN: 11/01/1999 AND 11/30/1999

BUS. SEG.: INCOHM

SUB EMPLOYEE NAME ADDRESS MEMBER-NO MEMBER NAME CLS EFF-DATE END-DATE DOB-DATE AGE

TELEPHONE

------------------------------------------------------------------------------------------------------------------------------------

CRUZ, MARGARITA D XXXX ALLISON STREET XXXXXXXXXX6 CANALES, FRANCISCO A DE 10/05/1996 12/31/9999 01/28/1979 21

(202)582-4013

BRENTWOOD

MD 20722

DIAZ, JORGE A XXXX 56TH AVE. XXXXXXXXXX3 DIAZ, ANDRES IBAN ST 04/01/1998 12/31/9999 02/04/1979 21

(301)927-2182

HYATTSVILLE

MD 20781

SOTO, VICTOR H XXXX HEWITT AVE #445 XXXXXXXXXX3 SOTO, HEIDY J ST 01/01/1999 12/31/9999 03/19/1979 20

(301)871-2038

SILVER SPRING

MD 20906

BOWIE, BARBARA M X HOSKINSON CT XXXXXXXXXX4 BOWIE, HOLLY L DE 08/01/1996 12/31/9999 05/13/1979 20

(301)972-8365

POOLESVILLE

MD 20837

OAKES, DAVID JOHN XXXXX COLLINGWOOD CO XXXXXXXXX03 OAKES, SHAWN C ST 01/01/1999 12/31/9999 07/21/1979 20

(703)494-4299

WOODBRIDGE

VA 22192

RADNOVICH, DIANA M XXXXX WOODMONT COURT XXXXXXXXXX4 RADNOVICH, CHRISTOPHER M DE 11/01/1998 12/31/9999 12/27/1979 20

(703)368-1460

MANASSAS

VA 20110

MHLEY, CORNELIUS L XXXX KEATS CT XXXXXXXXXX4 MHLEY, BRIDGET L ST 02/01/1999 12/31/9999 05/10/1979 20

(301)869-3197

ROCKVILLE

MD 20855

SMITH, LEROY XXXXX GEORGIA AVE. # XXXXXXXXXX3 SMITH, CAMILLE L ST 10/02/1998 12/31/9999 08/31/1979 20

(301)871-5605

Continue?

Sample Report 6:

GROUPCY-01 A.001.01 CENTREVILLE HEALTH, INC. PAGE: 1

02/08/00 10:57 AM GROUP/DIVISION MISSING BILL CYCLE REPORT

EFFECTIVE FROM 01/01/1998 THRU 12/31/9999

ALL TRANSACTION DATES

BUS. SEG.: INCOHM

====================================================================================================================================

DIVISION# HMOTST00DA BENEFIT TEST DA

AA PHONE1 EFF DATE: 01/01/1996

CONTACT: END DATE: 12/31/9999

DALLAS TX 75251 MARKETING REP: ANNIV DATE: 01/01

USA BILL CYCLE: TRANS DATE: 06/15/1998

MONTH CYCLE: ......0

ALT DIVISION: BENEFIT CAT(BC):

ATE ID

CYCLE DAY: 2510

DIVISION# HMOTST00EA BENEFIT TEST EA

AA PHONE1 EFF DATE: 01/01/1996

CONTACT: END DATE: 12/31/9999

DALLAS TX 75251 MARKETING REP: ANNIV DATE: 01/01

USA BILL CYCLE: TRANS DATE: 06/15/1998

MONTH CYCLE: ......0

ALT DIVISION: BENEFIT CAT(BC):

ATE ID

CYCLE DAY: 2510

DIVISION# HMOTST00IM BENEFIT TEST IM

AA PHONE1 EFF DATE: 01/01/1996

CONTACT: END DATE: 12/31/9999

DALLAS TX 75251 MARKETING REP: ANNIV DATE: 01/01

USA BILL CYCLE: TRANS DATE: 06/17/1998

MONTH CYCLE: ......0

ALT DIVISION: BENEFIT CAT(BC):

ATE ID

CYCLE DAY: 2510

DIVISION# HMOTST00IV BENEFIT TEST IV

AA PHONE1 EFF DATE: 01/01/1996

CONTACT: END DATE: 12/31/9999

DALLAS TX 75251 MARKETING REP: ANNIV DATE: 01/01

USA BILL CYCLE: TRANS DATE: 06/17/1998

MONTH CYCLE: ......0

ALT DIVISION: BENEFIT CAT(BC):

ATE ID

CYCLE DAY: 2510

DIVISION# HMOTST00LA BENEFIT TEST LA

AA PHONE1 EFF DATE: 01/01/1996

CONTACT: END DATE: 12/31/9999

DALLAS TX 75251 MARKETING REP: ANNIV DATE: 01/01

USA BILL CYCLE: TRANS DATE: 06/17/1998

MONTH CYCLE: ......0

ALT DIVISION: BENEFIT CAT(BC):

ATE ID

CYCLE DAY: 2510

Sample Report 7:

GRR250X-01 A.001.01 CENTREVILLE HEALTH, COMMUNITY HEALTH PLAN, INC. PAGE: 1

02/08/00 12:11 PM GROUP RENEWAL DATE REPORT

ENTERED 11/01/1999 THRU 11/30/1999

BUS. SEG: INCOHM

------------------------------------------------------------------------------------------------------------------------------------

GROUP# GROUP NAME

100661 ADVANCED SYSTEMS DEV. IN

# OF CONTRACTS # OF CONTRACTS # OF MEMBERS % OF ELIGIBLE

BROKER# BROKER NAME ELIGIBLE ENROLLED ENROLLED ENROLLED ANNV. DATE

203 INSURANCE MARKETING 0 83 171 0.00% 11/01/....

403 JULIAN H. GOOD, JR. 0 1 1 0.00% 11/01/....

536 WALTER MORGAN LEWIS, JR 0 3 10 0.00% 11/01/....

536 WALTER MORGAN LEWIS, JR 0 2 6 0.00% 11/01/....

--------- --------- --------- -------

GROUP TOTAL: 0 89 188 0.00%

GROUP# GROUP NAME

300250 BEN FRANKLIN PRESS

536 WALTER MORGAN LEWIS, JR 2 2 4 100.00% 11/01/....

--------- --------- --------- -------

GROUP TOTAL: 2 2 4 100.00%

GROUP# GROUP NAME

100751 FRALEY PLUMBING & HEATIN

536 WALTER MORGAN LEWIS, JR 2 1 2 50.00% 11/01/....

--------- --------- --------- -------

GROUP TOTAL: 2 1 2 50.00%

GROUP# GROUP NAME

100271 GLENMONT HEAT & AC INC.

523 INSURANCE ONE INC 15 16 31 106.67% 11/01/....

222 MARSHALL C. MILLER, P 15 13 24 86.67% 11/01/....

Sample Report 8:

Feb 08, 2000 11:12 SUSPEND GROUP REPORT AS OF DATE: Page 1

GROUP# NAME PAID THRU CYCLE CARRIER ANNIV. DATE SUS. DATE

010101 PRICING TEST 0 01 HM 19980101 19980101 1

100100 ALEXANDRIA PACKAGING 19990531 01 HM 19980601 19990531 1

100103 COLOR ME BEAUTIFUL 19990630 01 HM 19990701 19990701 1

100104 PROJECTION, INC. 19990831 01 HM 19930901 19990901 1

100105 PROFESSIONAL PRODUCTS 0 01 HM 19931001 19980331 1

100110 THE ELLERBE BECKET COMPA 0 01 HM 19940101 19971231 1

100111 ENERGY PUBLICATIONS ACQ. 19981231 01 HM 19931201 19981231 1

100112 J.K. AUTO PARTS, INC. 19990930 01 HM 19980401 19980331 1

100113 GPS MOBILE INC. 19981130 01 HM 19980401 19980331 1

100114 THOMAS MARKET II INC. 0 01 HM 19980401 19980331 1

100117 J M TAYLOR 0 01 HM 19940601 19971231 1

100120 U S ASIA COMMERCIAL 19990831 01 HM 19990701 19990831 1

100126 INTEGRATED COMPUTER SVC. 0 01 HM 19941201 19970131 1

100128 LEGAL ASSETS CORPORATION 19990414 02 HM 19950315 19990414 1

100145 UP TO DATE LAUNDRY 0 01 HM 19940801 19960731 1

100157 COOK'S MOVING & STORAGE 0 01 HM 19941001 19980630 1

100165 AUDIO VIDEO INTERNATIONA 0 01 HM 19941201 19980630 1

100172 FINAMARK, INC. 19990531 01 HM 19950101 19990531 1

100173 DR ALAN WEINSTOCK 19990228 01 HM 19000101 19980101 1

100176 RAM TREHAN, MD 0 01 HM 19950101 19961130 1

Sample Report 9:

GRR0300-01 A.001.01 CENTREVILLE HEALTH, COMMUNITY HEALTH PLAN, INC. PAGE: 1

02/08/00 11:26 AM MEMBERSHIP REPORT BY GROUP

EFFECTIVE FROM 11/01/1999 THRU 11/30/1999

BUS. SEG.: INCOHM

GROUP NAME: TUCKER, FLYER, & LEWIS

CONTRACT# NAME GROUP/DIV/ALT DIV CONTRACTYPE AA RP RG BP EFFDATE ENDDATE C-RY

MEM# NAME BIRTHDATE SEX NS CL EFFDATE ENDDATE M-RY

------------------------------------------------------------------------------------------------------------------------------------

XXXXXXXX8 ALEXANDER, SHAWN L 100101/0001/ SO DC IP LE 01/01/99 12/31/99 C2

01 ALEXANDER, SHAWN L 09/08/68 F EM DC 01/01/99 12/31/99 C2

XXXXXXXX2 BRINKLEY, CURTIS O 100101/0001/ SO DC LE 08/01/99 12/31/99 IN

01 BRINKLEY, CURTIS O 12/16/55 M EM DC 08/01/99 12/31/99 CP

XXXXXXXX5 COVINGTON, MICHELE Y. 100101/0001/ SO DC IP LE 01/01/99 12/31/99 C2

01 COVINGTON, MICHELE Y. 02/10/65 F EM DC 01/01/99 12/31/99 C2

XXXXXXXX6 DAVIS, STEPHANIE A. 100101/0001/ SF DC MI LE 01/01/99 12/31/99 C2

01 DAVIS, STEPHANIE A. 08/31/61 F EM DC 01/01/99 12/31/99 C2

02 DAVIS, PERCY 08/12/51 M SP DC 01/01/99 12/31/99 C2

03 BROWN, JUSTIN N. 06/11/87 M DE DC 01/01/99 12/31/99 C2

04 BROWN, JESSICA V. 06/19/89 F DE DC 01/01/99 12/31/99 C2

05 DAVIS, JORDAN E. 02/11/94 M DE DC 01/01/99 12/31/99 C2

These reports are Copyright @ 1999 Sophorn Reporting System. All rights reserved.

To receive more information contact:

C. C. Consulting, Inc.

6611 McCambell Cluster

Centreville, VA 20120

Tel:(703)222-0822

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[email protected]

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Revised: May 13, 2000.

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