ClaimBook MIS Reports 1 - Payer Performance MIS Report
ClaimBook MIS Reports
ClaimBook has three monthly MIS Reports
1.Payer Performance MIS Report
2.Operations Performance MIS Report
3.Revenue Leakage MIS Report
1. Payer Performance Report
- Footfall Report has report two charts
- Payer wise Case Submissions Count. This shows count of Payer/TPA cases submitted for the selected month. The Payer/TPA cases are categorized into "Top 9" Payers based on the count of cases and remaining payer cases are grouped in "Others". The report will have Payer/TPA name, total No of cases, Estimated bill amount and percentage of cases.
- Payer wise Case Submissions Count. This shows count of Payer/TPA cases submitted for the selected month. The Payer/TPA cases are categorized into "Top 9" Payers based on the count of cases and remaining payer cases are grouped in "Others". The report will have Payer/TPA name, total No of cases, Estimated bill amount and percentage of cases.
- No. of Submissions and Discharges per day in this month will have horizontal axis representing number of Initial (New Preauth) submissions and Discharge submissions per day.
- The TAT Report will have two reports
- Preauth/Enhancement Approval TAT Report will have bar chart describing the PreAuth/Enhancement approval TAT for the selected month. TAT is calculated from Preauth/Enhancement submission till the Approval.
- Preauth/Enhancement Approval TAT Report will have bar chart describing the PreAuth/Enhancement approval TAT for the selected month. TAT is calculated from Preauth/Enhancement submission till the Approval.
- Discharge/Revision Approval TAT Report will have bar chart describing the Discharge/Revision Approval TAT for the selected month. TAT is calculated from Preauth/Enhancement submission till the Approval.
- Settlement & Outstanding Report shows Payer wise Settlement report with TAT & Payer wise Outstanding Report with aging .
- Payer wise Settlement Report shows the Settlement amount value for the selected month with percentage. The Payers are categorized as "Top 5 Payers" while the rest of the payers are grouped in "Others".
- Payer wise Settlement Report shows the Settlement amount value for the selected month with percentage. The Payers are categorized as "Top 5 Payers" while the rest of the payers are grouped in "Others".
- Settlement TAT Report shows the TAT for Claim Submission to Claim Settlement update in ClaimBook. The chart has time intervals in days in the horizontal axis. Total number of payer specific cases in Count & Percentage represented along the vertical axis.
- Payer Wise Outstanding Report shows the Total Payer wise outstanding cases with Value & percentage for the selected month. Outstanding cases are Claim Submitted cases awaiting Claim Settlement.
- Outstanding Aging Report shows the Payer Wise aging of the Claims Submitted cases in count for the selected month. The chart shows time intervals in days in the horizontal axis. Total number of payer specific cases in Count represented along the vertical axis.
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