RCM
Claims, collections & payment lag
Total charges
$19,309,667
Total paid
$3,673,278
19.0% of charges
Collection rate (adjudicated)
22.0%
paid ÷ charges where balance is settled
Open insurance balance
$3,254,236
Patients
111
across 7 payers
Median payment lag
2.0 wks
payment date vs date of service
Charges vs paid by billing week
Weeks ending Friday, 16 most recent — recent weeks are still adjudicating
Payment lag curve
$ collected by weeks after date of service, with cumulative %
By payer
Top 7 primary payers by charges
| Payer | Claims | Charges | Paid | % of charges | Open balance |
|---|---|---|---|---|---|
| Anthem Medicaid | 6,517 | $5,213,610 | $1,044,463 | 20.0% | $675,917 |
| CareSource | 5,310 | $4,248,127 | $805,772 | 19.0% | $745,148 |
| Ohio Medicaid | 3,862 | $3,089,547 | $530,942 | 17.2% | $531,909 |
| Buckeye | 2,896 | $2,317,160 | $445,068 | 19.2% | $318,463 |
| Anthem BCBS Ohio | 2,414 | $1,930,967 | $471,943 | 24.4% | $348,485 |
| Aetna | 1,690 | $1,351,677 | $336,468 | 24.9% | $214,003 |
| United | 1,448 | $1,158,580 | $271,279 | 23.4% | $211,207 |
By procedure code
Top 5 codes by charges
| Code | Claims | Units | Charges | Paid | Paid / unit | % of charges |
|---|---|---|---|---|---|---|
| 97153 | 17,649 | 211,783 | $13,130,574 | $2,655,885 | $12.54 | 20.2% |
| 97155 | 6,098 | 24,391 | $2,317,160 | $502,263 | $20.59 | 21.7% |
| 97151 | 1,755 | 14,043 | $1,544,773 | $354,737 | $25.26 | 23.0% |
| 97154 | 4,096 | 24,576 | $1,351,677 | $262,647 | $10.69 | 19.4% |
| 92507 | 3,714 | 7,427 | $965,483 | $234,002 | $31.51 | 24.2% |
Authorizations
From the latest weekly authorization report — patients shown by Pat ID only
Active authorizations
214
today within start/end, auth required
Expiring ≤ 30 days
31
Expiring ≤ 60 days
70
Low units remaining
18
under 15% of allowed units left
Soonest-expiring active authorizations
Next 15 to expire — reauthorize before these lapse
| Pat ID | Payer | Code | End date | Units remaining / allowed |
|---|---|---|---|---|
| 4253 | Buckeye | 97153 | Jul 13, 2026 | 96 / 738 |
| 4587 | Anthem BCBS Ohio | 97151 | Jul 14, 2026 | 369 / 570 |
| 4587 | Ohio Medicaid | 97155 | Jul 15, 2026 | 147 / 577 |
| 4315 | Ohio Medicaid | 97153 | Jul 15, 2026 | unlimited |
| 4920 | Ohio Medicaid | 97155 | Jul 16, 2026 | 475 / 602 |
| 4977 | United | 97154 | Jul 17, 2026 | 577 / 851 |
| 4156 | CareSource | 97154 | Jul 17, 2026 | unlimited |
| 4180 | Buckeye | 97155 | Jul 19, 2026 | 312 / 822 |
| 4652 | Buckeye | 97155 | Jul 19, 2026 | 136 / 924 |
| 4408 | United | 97151 | Jul 20, 2026 | 284 / 792 |
| 4867 | Aetna | 97151 | Jul 20, 2026 | 120 / 506 |
| 4349 | Aetna | 97153 | Jul 20, 2026 | 57 / 612 |
| 4222 | Buckeye | 97151 | Jul 20, 2026 | 275 / 402 |
| 4890 | Aetna | 97151 | Jul 21, 2026 | 930 / 1,150 |
| 4329 | United | 97153 | Jul 21, 2026 | 116 / 939 |