- 28 Mar 2025
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Reporting
- Updated on 28 Mar 2025
- 6 Minutes to read
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- PDF
Claim.MD allows you to generate detailed reports for your processed claims, providing valuable insights into your billing performance. By reviewing these reports, you can analyze key data, identify issues with specific payers or procedures, and monitor the status of your claims. The reports are designed in a user-friendly format, making it easy to track and manage your billing and reimbursement activities.
With Claim.MD’s powerful reporting functionality, you can efficiently oversee your claims and optimize your billing operations.
Steps to Generate Reports
- Click Reporting in the left-hand navigation menu.
- To create a new report, click the button at the top of the screen.
- The Generate Report window will appear. Here, you can use various filters to customize and generate reports based on Claim.MD data.
- Once you've selected the desired criteria, click to create the report.
Report Dropdown Options
Report Types
Each report type in Claim.MD allows users to search for data based on specific criteria that vary depending on the selected report. All reports are interactive, enabling users to click on individual claims within a segment to access more details. Refer to the table below for descriptions of the different report types available in Claim.MD.
Report Type | Description |
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Billed Charges by Payer | This report provides a summary of the total amount billed to each payer for a specified time period. It includes the payer's name, total billed charges, and additional details for each claim submitted to that payer.
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Billed Charges by Rendering Provider | This report summarizes the total amount billed for services provided by each rendering provider (e.g., physicians or other healthcare practitioners) within a specific time period.
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Billed Charges by Billing Provider | This report displays the total amount billed by each billing provider within a specified timeframe.
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Billed Charges by Billing Facility | This report summarizes the total amount billed for services provided by each facility, such as hospitals, clinics, or outpatient centers, over a specific time period. Key details included:
This report helps track the billing performance of individual facilities, identify trends in service utilization, and ensure accurate billing for rendered services. Report options: Claim Group, Time Frame, Select By |
Billed Charges by Procedure | This report summarizes total billed charges categorized by procedure codes within a specified timeframe.
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Transmits | This report provides details on claims transmitted within the last 30 days, categorized as either Transmitted (submitted once) or Re-Transmitted(submitted multiple times).
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Top Rejections | This report identifies the most common reasons for claim rejections within a specified time period.
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Claim Corrections | This report provides insights into claims that have been corrected and resubmitted after rejection or denial.
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Age of Billing | This report tracks the number of days between the date of service and the last claim submission.
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Payments / Adjustments | This report provides details on payments and adjustments applied by payers to submitted claims.
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Time Till Payment | This report measures the time it takes for claims to be processed and paid.
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Patient Demographics | This report provides a visual representation (e.g., a map) of the geographical distribution of a provider's patients.
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Claims Activity | This report tracks the status and activity of submitted medical claims.
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Avg. Payment Comparison by Procedure | This report compares the average amounts paid and billed for each procedure or service. It also provides a global comparison for the same procedures. Benefits of this report:
Report options: Claim Group, Time Frame |
Appeals Activity | This report provides insights into appeals submitted by healthcare providers to payers. Appeals are categorized by submission method:
By analyzing this report, providers can track appeal status, monitor trends, and identify the most effective appeal submission methods. Key insights:
Report options: User, Claim Group, Time Frame |
Payer-Modified CPT/HCPC | This report lists procedure codes that were modified by the payer during claim adjudication. Clicking on a code will display a list of affected claims. Report options: Claim Group, Time Frame |
Deleted vs. Archived Claims
Deleted claims are those that were uploaded but never transmitted. Claims in this category will not show successful resubmissions. Once a claim has been deleted, it cannot be removed from the report.
Archived claims refer to claims that have been both uploaded and transmitted.
Additional Report Filters
Claim Group
Customized drill-down filters allow grouping claims for more specific reporting. Examples include:
- Paid vs. Unpaid Claims
- Secondary Providers
For details on setting up claim groups, see the Claim Grouping article.
Time Frame
Defines the date range for reporting data.
Note: When selecting "Other" for date selection, the range must be one year or less.
When generating reports, a pie chart and a list view are displayed, both of which are interactive for deeper claim analysis.
Select By
Sorts report data based on:
- Last Transmit Date
- First Date of Service
Report View
When a report is generated, a chart or graph displays segmented data based on the selected report type.
- For example, the Billed Charges by Payer report shows billed claims and their amounts by payer.
- Clicking a pie chart segment reveals a list of all claims under that payer.
- Users can then View/Edit Claims, add notes, or perform additional actions.
For more details, see the View/Edit Claims article.
Exporting Reports
To export report data as a CSV file, click the icon in the top-right corner of the screen. The file can then be opened in spreadsheet applications such as Excel.
Adding Criteria to Refine Claim Searches
Users can refine claim lists generated from reports for deeper data analysis.
How to Add Search Criteria:
- Run a Report: Generate a report (e.g., "Billed Charges by Payer").
- Select a Data Point: Click on a pie chart segment or a payer name in the report.
- Access Additional Search Options: Click the gear icon in the upper-right corner.
- Add Search Criteria: Use available filters to refine the report.
Example: In the image below, Procedure and Modifier criteria are selected.