States and Providers Overview
The States and Providers Overview report is a one-pager overview on States and Providers performance.
Generating the Report
Note
Once selected, the report will update automatically with the metrics specified.
In the Report Navigation Menu, click States and Providers Overview.
In the Right Side Filters panel, select if you want to include claims that have been Denied.
N: Do not include denied claims.
Y: Include denied claims.
Verify that your company name is selected in the Client Name filter. It will be checked by default.
Using the Left Side Filters, select a Date Range. In the first field choose a start date and in the second field, an end date.
If applicable, refine the data results by Network. Data will appear for rectangles that are black. Clicking a rectangle deselects it.
Choose for which Service Type you want the data to be displayed:
Inpatient: medical claims from institutions that require overnight hospitalization (e.g., hospitals)
Outpatient: medical claims from institutions that do not require overnight hospitalization (e.g., ambulatory care)
Professional: medical claims from professionals (e.g., individual doctor's office)
States and Providers Overview Explained
The States and Providers Overview report features a Heat map, a Percentage, a Bar chart, and a two Metrics tables. The following section provides details for each of these elements.
Note
Billed Amount, Eligible Amount, Discount Amount, and Claim Count are visualized based on a claim's last processed date. (For a more detailed explanation see Section : “The Reports” page)
Gross Discount % by Provider State:
The blue scales denotes how large the gross discount percentage within that state is. The darker the blue, the higher the gross discount percentage.
Note
If the state is grey, there are no claims associated to that state.
Selecting a state will update the Top 15 Providers by Eligible Amount and Claim Size visualizations to be filtered down to that selected state.
This visualization can be filtered by provider, by selecting a provider in the Top 15 Providers by Eligible Amount visualization.
If there are some claims that do not have the "state" information, they are categorized as "Unknown". Due to the US map visualization only showing claims with state information, a message will prompt to let you know what percentage of claims are actually displayed in the Heat map.
Overall Discount % across all states: Percentage of gross discount among eligible amount (Gross Discount / Eligible Amount)
Top 15 Providers by Eligible Amount – across all states:
A list of the top 15 providers based on the total dollar amount of processed claims that were eligible.
Selecting a provider will filter the Gross Discount % by Provider State and Claim Size visualizations to that specific provider.
This visualization can be filtered:
By state, by selecting a state in the Gross Discount % by Provider State visualization
By Eligible Amount Bin, by selecting a row from the Claim Size visualization
States by Eligible Amount:
A list of all states sorted by Eligible Amount with a more detailed view of Gross Discount Amount and Gross Discount %.
Selecting a row from the list will filter the Top 15 Providers by Eligible Amount to that specific state.
Claim size across all states:
Grouping claims by eligible amount bins to show the distribution of claims (claims count, eligible amount, gross discount amount, and gross discount %).
Selecting a row from the list will filter the Top 15 Providers by Eligible Amount and States by Eligible Amount visualizations for that Eligible Amount Bin.
This visualization can be filtered by state, by selecting a state in the Gross Discount % by Provider State visualization.