Enterprise Healthcare RCM Command Center

Executive Summary

Filters dynamically recalculate all targets, metrics, & data across the system.

Hospital

Date Segment

Department

Specialty

Insurance Payor

Chief Provider

Claims Submitted

3,240

+4.2% MoM

Total Revenue

$12.4M

+2.8% MoM

Net Collection %

96.4%

Benchmark: >95%

Clean Claim Rate

94.1%

Benchmark: >95%

First Pass Res.

92.8%

Benchmark: >90%

Denial Rate

6.42%

Benchmark: <5.0%

Accounts Rec. (AR)

$4.12M

Aging focus needed

Avg Days in AR

43.2

Benchmark: <40 Days

Collection Rate

96.1%

Gross cash conversion

Bad Debt %

1.65%

Benchmark: <2.0%

KPI Target Threshold Status: Target Achieved (🟢) Attention Required (🟡) Critical / Underperforming (🔴)

Revenue Trend (Monthly)

Claims Submission Volume

Collection Efficiency vs Goal

Waterfall Revenue Leakage ($ Millions)

STAGE 1

Gross Charges

$15.2M

100% baseline

LOSS 1

Denial Write-Offs

-$1.14M

7.5% drop

LOSS 2

Underpayments

-$0.84M

5.5% drop

LOSS 3

Missing Charges

-$0.42M

2.8% drop

STAGE 2

Net Collections

$12.8M

84.2% yield

Total Denied Amount

$842.1K

Highest source: Auth Issues

Denial Rate %

6.42%

Benchmark target: <5%

Rejected Claims Count

482 Claims

Critical attention needed

Reworked Claims %

78.5%

Recovery cycle active

Top Denial Reasons

Denial Amount by Department

Denial Trend Line

Insurance Company × Denial Reason Heatmap ($)

Reason	Blue Cross	UnitedHealth	Aetna	Cigna
Auth Missing	$124,000	$145,000	$89,000	$102,000
Eligibility Issue	$76,000	$98,000	$45,000	$62,000
Coding Error	$45,000	$65,000	$54,000	$38,000
Medical Necessity	$22,000	$51,000	$34,000	$19,000

Dynamic Denial Recovery Smart Insights

42% of all denial events trace directly to Authorization Issues. Recommended workflow tracker is suggested.
28% of all hospital-wide rejections are coming out of the Radiology department. Priority alignment required.

Total AR Balance

$4.12M

Aging optimization active

Days in AR

43.2 Days

Above benchmark (40)

AR > 90 Days

22.4%

Goal limit: <15%

Collection Efficiency

94.8%

Strong net recovery rate

AR Aging Distribution (%)

AR Balance by Insurance Company

AR Balance by Department

Aging Heatmap Profile (Dept × Aging Category)

Department	0-30 Days	31-60 Days	61-90 Days	91-120 Days	120+ Days
OPD	$340K	$210K	$89K	$45K	$76K
ER	$450K	$190K	$124K	$198K	$240K
Radiology	$180K	$95K	$110K	$89K	$145K
Cardiology	$210K	$85K	$45K	$38K	$62K

Accounts Receivable Intelligence Insight

analysis indicates that 65% of AR balance exceeding 90 days is currently clustered across only two major insurance carriers. Target collections review scheduled for clinical managers.

Registration Accuracy

97.2%

Benchmark target: >95%

Coding Accuracy

96.8%

Benchmark target: >95%

Auth Compliance

91.4%

Benchmark target: >98%

Submission Turnaround

2.4 Days

Exceeding standard speeds

Department Scorecard

Outpatient Dept (OPD) 95%

Emergency Room (ER) 82%

Radiology 71%

Cardiology 98%

Provider RCM KPI Metrics

Provider Name	Claim Error Rate	Auth Compliance	Average Charge lag	Status
Dr. Sarah Jenkins	1.8%	99.1%	1.2 Days	EXCELLENT
Dr. Mark Raymond	4.2%	89.4%	3.5 Days	WARNING
Dr. Elena Carter	2.1%	97.8%	1.8 Days	GOOD

Claims Processing Turnaround Time (Days)

Authorization Compliance Month-over-Month (%)

RCM Action Plan & Corrective Tracker

Executive level oversight of action workflow items to resolve operational issues.

Issue / Leakage Event	Root Cause	EGP/USD Impact	Priority	Action Plan Remediators	Task Owner	Due Timeline	Status

Executive Summary

Revenue Trend (Monthly)

Claims Submission Volume

Collection Efficiency vs Goal

Waterfall Revenue Leakage ($ Millions)

Gross Charges

Denial Write-Offs

Underpayments

Missing Charges

Net Collections

Top Denial Reasons

Denial Amount by Department

Denial Trend Line

Insurance Company × Denial Reason Heatmap ($)

Dynamic Denial Recovery Smart Insights

AR Aging Distribution (%)

AR Balance by Insurance Company

AR Balance by Department

Aging Heatmap Profile (Dept × Aging Category)

Accounts Receivable Intelligence Insight

Revenue Leakage Conversion Funnel

Lost Revenue by Department

Underpayment Amount by Payor

Revenue Leakage Dynamic Intelligence

Department Scorecard

Provider RCM KPI Metrics

Claims Processing Turnaround Time (Days)

Authorization Compliance Month-over-Month (%)

RCM Action Plan & Corrective Tracker

Smart AI Assistant Real-time Performance Overview

EXECUTIVE HIGHLIGHT

RCM AI Business Analyst Copilot

Revenue Trend (Monthly)

Claims Submission Volume

Collection Efficiency vs Goal

Waterfall Revenue Leakage ($ Millions)

Gross Charges

Denial Write-Offs

Underpayments

Missing Charges

Net Collections

Top Denial Reasons

Denial Amount by Department

Denial Trend Line

Insurance Company × Denial Reason Heatmap ($)

Dynamic Denial Recovery Smart Insights

AR Aging Distribution (%)

AR Balance by Insurance Company

AR Balance by Department

Aging Heatmap Profile (Dept × Aging Category)

Accounts Receivable Intelligence Insight

Revenue Leakage Conversion Funnel

Lost Revenue by Department

Underpayment Amount by Payor

Revenue Leakage Dynamic Intelligence

Department Scorecard

Provider RCM KPI Metrics

Claims Processing Turnaround Time (Days)

Authorization Compliance Month-over-Month (%)

RCM Action Plan & Corrective Tracker

Smart AI Assistant Real-time Performance Overview

EXECUTIVE HIGHLIGHT

RCM AI Business Analyst Copilot

Add Corrective Action Remediator