OVERVIEW:
Open claims and closed payer claims data are essential for understanding the status and activities of patients along their healthcare journey. Both open claims data and closed payer claims data provide unique benefits that make each suitable for different types of research by life sciences companies.
Open claims
Open claims encompass multiple data types, they offer insights into patient touch points across the healthcare landscape with no limitations on time frame. The recency of this data is a key differentiator—many medical, pharmacy and lab visits within the open claims data can be seen as recently as yesterday, offering near-real-time reporting and tracking. Standard data fields, such as ICD-10 codes and CPT codes, are available in addition to submitted and paid cost information, physician information, referring NPI, place of service and more.
Closed Claims
Closed payer claims data is derived from health insurance providers (payers), revealing nearly all of a patient’s healthcare activities during a specific enrollment period. This includes ICD-10 codes, CPT codes, physician and specialty information, geographic information, as well as nearly all medical and pharmacy claims. This reveals a valuable look into the patient journey and connects patients’ diagnoses, actions and decisions along the way with minimal gaps. This data also includes commercial, Medicare and Medicaid plans with an average lag time of 90 days, typically much longer than that of open claims data.