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Nov 15 th , 2010

Quality Assurance:. Quality Assurance 2010 Initiatives – Report Card. Nov 15 th , 2010. Client Server Testing Mainframe Testing : Qcare Change Management IT Operating Model . 2010 Project Initiatives – Client Server Testing.

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Nov 15 th , 2010

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  1. Quality Assurance: Quality Assurance 2010 Initiatives – Report Card Nov 15th , 2010 Client Server Testing Mainframe Testing : Qcare Change Management IT Operating Model

  2. 2010 Project Initiatives – Client Server Testing The below outlines the 2010 Initiatives that has been successfully implemented with Quality Assurance & IT Controls teams involvement • Kenexa Implementation • QualCare • Interface – Data Validation • Letter Generation Upgrade • Interface Testing • PeopleSoft 9.0 Upgrade • Interface Testing • Three Big Treasury projects • Client Letter implementation • CRS Replacement • Interface – Data Validation • Varicent 1 • End To end testing (Functional – Regression) • Performance Testing • Hyperion • End To end testing (Functional – Regression) • Interface – Data Validation • Performance testing • ImageNow • End To end testing (Functional – Regression) • Performance Testing • HCRA • Managed Long Term Care • Interface Testing www.emblemhealth.com

  3. 2010 Project Initiatives – Mainframe Testing: Qcare The below outlines the 2010 Initiatives that have been successfully implemented with Quality Assurance & IT Controls teams involvement • ATQ • Qcare Claims Regression Testing • COB Savings • Qcare Claims Regression Testing • Orthonet • Qcare Claims Regression Testing • Qualcare • Qcare Claims Regression Testing • PT/OT Palladian Post Implementation • Qcare Claims Regression Testing • Facility Provider Contract Load • Qcare Claims Regression Testing • VV1 Pricing • Qcare Claims Regression Testing • Facility Med Pricing • Qcare Claims Regression Testing • Non Par Lab Fee Schedule • Qcare Claims Regression Testing • Medicare 2009 Req 72.0 • Qcare Claims Regression Testing • APG Integrated Solution • Qcare Claims Regression Testing • DRG Prepayment Phase 2 • Qcare Claims Regression Testing • Managed Care Bill/ prompt Pay • Qcare Claims regression testing • Newborn Claims Processing • Qcare Claims regression testing • MLTC • Qcare Claims regression testing • HIP Go Paperless • Qcare Claims regression testing www.emblemhealth.com

  4. 2010 Project Initiatives – Mainframe Testing: Qcare The below outlines the 2010 Initiatives that have been successfully implemented with Quality Assurance & IT Controls team’s involvement • HCRA • Qcare Claims Regression Testing • Provider Contract Detail Load • Qcare Claims Regression Testing • Edits 015, 016, 017 and 050 • Qcare Claims Regression Testing The below represents the 2010 Initiatives that are still in progress • Threshold Phase 2 • Qcare Claims Regression Testing • Orthonet Phase 2 • Qcare Claims Regression Testing • COBA • Qcare Claims Regression Testing • Billed Charges Multiplan • Qcare Claims Regression Testing • CPT File Calculation • Qcare Claims Regression Testing www.emblemhealth.com 3

  5. 2010 Project Initiatives – Change Management The below outlines the 2010 Initiatives that has been successfully implemented with Quality Assurance & IT Controls teams involvement • Consolidated Change Management Policy and Procedure • Robert Allen has approved the policy and procedure • Consolidated Test Plan and Risk information • Users are now starting to use Emblem Health test plan and risk documentation • Consolidated Change Management Monthly Metric Report • Automated two reports into one Emblem health report • Coordination of PNMS workflow • Support Data control and mainframe application team with coordination of PNMS workflow • Guidance of PPM Change Management for HIP Staff • Provide guidance and assistance on workflow comprehension • Change Management Process Consolidation • Supported any questions from CAB representatives • Group/Category Creation and Consolidation • Consolidated categories that were inactive for the year • Legacy GHI Unicenter Training • Support extensive Unicenter training to GHI staff • Introduce GHI Users to Unicenter Service Desk Change Module • Prepare training classes • Prepare manuals for support of the transition • Merge Change Advisory Board • Merge two CAB meetings into one • Assisted CAB members in understanding the purpose of the CAB merger www.emblemhealth.com

  6. 2010 IT Operating Model • Microfocus - Compuware • QA continues to utilize this tool and expand into automation • QA is currently beginning the move to use functional test cases as regression test cases • QA has a resource dedicated to full use of the tools and reducing the test time and promoting test accuracy • Quality Center • Quality Center has been implemented and rolled out with the automation framework for the Pilot Project (PeopleSoft) • Tool is currently being used for Varicent 2, Siebel • Endevor • Endevor product has been implemented. • Harvest • Harvest has been implemented and the pilot project (PeopleSoft) is currently utilizing the product for development work • Data encryption and test data management • Although QA has not been required to use data encryption, the data encryption has been completed as far as proving • out that tests can be run with encrypted data. We ran a test and encrypted all the recommended fields on the claims • records and also encrypted all the appropriate member files to create unrecognizable ssn, addresses and member id. • The claims test proved that the encrypted data provided the same results as non encrypted data. The below outlines the 2010 IT Operating Initiatives that has been successfully implemented www.emblemhealth.com

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