What is a Claims Analysis Dashboard?

Claims Dashboards are considered payor and reimbursement analysis tools and are used by CFOs and medical billing managers to analyze KPIs related to claims. Some of the main functionality in this type of dashboard is that it uses KPIs, a matrix and charts to provide analysis in seven areas: 1) Total charges and reimbursement amounts, 2) Number of claims and claims paid, 3) Payor report matrix with charges, reimbursements, number of claims, number of claims paid, percent of claims paid, 4) Total charges KPI (amount), Total number of claims KPI, Total reimbursements KPI (amount), and Total number of claims paid KPI. You find an example of this type of dashboard below.

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Purpose of Claims Analysis Dashboards

Healthcare organizations use Claims Analysis Dashboards to give managers a single place to easily review claims metrics. When used as part of good business practices in Financial Planning & Analysis (FP&A) and Billing departments, an organization can improve its payor and claims processes, and it can reduce the chances that revenues are lost due to lack of analysis and oversight.

Example of a Claims Analysis Dashboard

Here is an example of a Claims Analysis Dashboard with payor detail and KPIs.

Example of a Claims Analysis Dashboard for Healthcare Providers

Example of a Claims Analysis Dashboard for Healthcare Providers

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Who Uses This Type of Dashboard?

The typical users of this type of dashboard are: CFOs, medical billing manager, collections manager, accountants, analysts.

Other Reports Often Used in Conjunction with Claims Analysis Dashboards

Progressive Financial Planning & Analysis (FP&A) and Billing departments sometimes use several different Claims Analysis Dashboards, along with profit & loss reports, cash flow statements, annual budgets and forecasts, revenue dashboards, billing reports, charges reports, collections reports, aged receivables (AR) reports, payor reports, claims reports and other management and control tools.

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Where Does the Data for Analysis Originate From?

The Actual (historical transactions) data typically comes from enterprise resource planning (ERP) systems like: Microsoft Dynamics 365 (D365) Finance, Microsoft Dynamics 365 Business Central (D365 BC), Microsoft Dynamics AX, Microsoft Dynamics NAV, Microsoft Dynamics GP, Microsoft Dynamics SL, Sage Intacct, Sage 100, Sage 300, Sage 500, Sage X3, SAP Business One, SAP ByDesign, Acumatica, Netsuite and others.

In analyses where budgets or forecasts are used, the planning data most often originates from in-house Excel spreadsheet models or from professional corporate performance management (CPM/EPM) solutions.

What Tools are Typically used for Reporting, Planning and Dashboards?

Examples of business software used with the data and ERPs mentioned above are:

  • Native ERP report writers and query tools
  • Spreadsheets (for example Microsoft Excel)
  • Corporate Performance Management (CPM) tools (for example Solver)
  • Dashboards (for example Microsoft Power BI and Tableau)

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