I work for the largest health insurer in the U.S. Actually, we are now global. Our claims system is a relational DB and is normalized. Our DD is pretty close to being perfect and I know it is impossible to come up with every scenario on the planet to add to a DD. Here is the issue; When we hit numerous tables, whether doing an inner join, left join or left outer join, often times the data that is in the main claims table is duplicated. Example, we hit our member table and it will cause the claim number and monetary values to come over 2 or more times. My Assoc. Director is trying to say this is a DD problem and our DD is incomplete or not accurate. I have asked for examples and until this very moment, he has provided 0. However, another analyst on my team provided me with 1 example. I was able to trace back to the member table and found the reason it was returning duplicates was because on our finc_arng_cd column, the member had an A for ASO and null for the 2nd line. I explained you need a filter for A on the finc_arng_cd. She did that and it worked. I included my Assoc. Director in the information and explained if you get duplicate returns on our main claims table (which contains 6 primary keys and our BA's have stated there are no duplicates in the main claims table. It is set up to make sure that never happens) then it is something wrong with his code. Of course, he is arguing with me about this. So, instead of doing some simple research and back tracking to see what is causing the duplication and then re-coding appropriately, he has so far created a 19 1/2 page SAS code that hits so far 11 table separately. He has no joins at all. He is simply hitting the claims table first and pulling out what he wants. Then a separate query to hit the provider table and pulling what he wants. And so on. He also put these macros and loops in and right now the code does a loop and looks at 100 records at a time. 1) The way he is coding tells me that he is treating our claims system as though it contain no relationships and is not normalized. 2) His coding to me is old and if he receives duplicates then his code is wrong. 3) This looping 100 records at a time is inefficient because our projects return millions of records. I have one project that returns over 8 million records. Using his 100 at a time looping, I think my computer would crash or it would take forever to run and I would probably use all the temp space in the database and the admins of our claims system would shut me down. Does anyone have any input they can provide that can further my proof that he really has no clue what he is doing and proposing we code this way to our director is going to cost time and time is money.
... View more