Billing analytics

The Analytics section includes ten reports. The first seven follow an insurance claim from submission through to payment; the last three cover appointments, form responses, and courses.

Claims Submitted: Monitor claim submission activity over time
Clean Claim Rate: See how often claims are submitted cleanly without requiring corrections
Claim Denials: Track denial volume and identify patterns
Underpayment & Variance: Identify when payer reimbursement differs from expected amounts
Payments Posted: See what was actually collected, from insurance and from patients
Aging Reports: Understand outstanding balances and where accounts receivable is getting stuck
Revenue Forecast: Project the collections expected over the next twelve months
Appointments: Track appointment volume, completion, cancellation, and no-show rates
Form Responses: Track how many forms patients are finishing, and how they score
Course Analytics: See how courses are performing and which patients need outreach

Prerequisites

Part 1: Turn on the required permissions (EMR)

Each report has its own toggle under Settings > Organization > Access Controls, in the "Analytics" section. A specialization only sees a report in the Analytics menu when its toggle is on:

Can view aging report analytics
Can view payments posted analytics
Can view billing overview analytics
Can view claim denial analytics
Can view appointment analytics
Can view form response analytics
Can view course report analytics

Claims Submitted, Clean Claim Rate, Underpayment & Variance, and Revenue Forecast do not have their own toggles yet, so they are visible to every organization member who can reach the Analytics menu.

Follow the instructions here to set access controls.

Opening a report

Go to the EMR (e.g. emr.avonhealth.com)
Click on the hamburger menu on the top left corner > Analytics
Pick a report from the Analytics panel. Click "Back" to return to the main menu.

The seven revenue cycle reports share the same controls:

Date range: Two date fields with quick-range buttons (30 days, 90 days, 180 days, 12 months). The heading on the right of the page confirms which dates and which date basis are in use.
Filters: Medical Center, Service Facility, Rendering Provider, Billing Provider, and on some reports Payer or Patient. Filters are multi-select and are saved in the page URL, so a filtered view can be bookmarked or shared.
Payer categories: Where a report groups by payer category, the categories are Commercial, Medicare, Medicaid, Self-Pay, and Other, based on the plan type on the patient's primary insurance policy. "Self-Pay" is a claim with no primary insurance policy.
Group rows by: Switch a table between one row per payer and one row per payer category.

Payments Posted, Appointments, Form Responses, and Course Analytics are older reports with controls of their own. Those are described with each report below.

Claims Submitted

Monitor claim submission activity over time: how many claims went out, how much was billed, how quickly, and which procedures and payers made up the volume.

What it counts: Every submitted claim, dated by its first submission
Date range: Submitted Date Range, default last 90 days
Filters: Medical Center, Service Facility, Rendering Provider, Billing Provider
Tiles: Total Encounters (service lines on submitted claims, with the average charge per line), Total Charges, Claims Submitted (with the number of secondary claims), Days to Submission (average days from the last date of service to submission, with the share of claims that needed resubmission)
Chart: "Submission activity by week", with charges as bars and claim count as a line
Tables: "Top procedure codes and payers". Use "Rank By" to order both tables by volume or by charges. The CPT table shows lines, units, charges, and share of charges per code. The payer table shows claims, units, charges, and share of charges per payer. Each lists the top ten with an "All other" row and a total.

Clean Claim Rate

See how often claims are submitted cleanly without requiring corrections. The report shows the share of submitted claims that were never rejected by the clearinghouse.

What it counts: The same submitted claims. A claim is clean if it was never "Rejected". Only a clearinghouse rejection makes a claim unclean — a payer denial does not.
Date range: Submitted Date Range, default last 90 days
Filters: Payer, Medical Center, Service Facility, Rendering Provider, Billing Provider
Tiles: Clean Claim Rate, Claims Rejected by Clearinghouse, Charges on Rejected Claims, Total Charges Submitted
Chart: "Clean claim rate by month"
Tables: "Top clearinghouse rejection reasons", taken from the rejection messages returned with each claim, and "Clean claim rate by payer"

Claim Denials

Track denial volume and identify patterns. The report lists every denial-type adjustment reported on the organization's remittances, showing which codes and payers cost the most.

What it counts: Denial lines on posted remittances — CO, OA, or PI adjustments whose reason code means a denial. Contractual write-offs such as CO-45, and anything billed to the patient (PR), are not denials. Each denial is dated by the remittance's payment date.
Date range: Denial Date Range, default last 180 days
Filters: Payer, Medical Center, Service Facility, Rendering Provider, Billing Provider
Tiles: Total Denials (a count of denied lines, with the total amount adjusted), Denial Rate (claims with a denial as a share of claims with any remittance in range), Total Adjustments (as a share of the amount billed on those lines)
Charts: "Denials by Denial Code", with the CARC description on hover, and "Denials by Payer"
Table: "Insurance Denials" with Provider, Denial Date, Claim #, Patient Name, DOS From, DOS To, Procedure Code, Insurance, Billed, Paid, Denial Amount, Denial Code, and Claim Status. Click a row to open the claim.

Underpayment & Variance

Identify when payer reimbursement differs from expected amounts. The report compares what each remittance said it would allow with what it actually paid.

What it counts: Every remitted charge showing a charged, allowed, and paid amount. Variance is Paid minus Allowed; Variance % is that divided by Allowed. Negative means the payer paid less than it said it would allow. "Expected" is the payer's own allowed amount, not the practice's fee schedule.
Date range: Remittance Date Range, default last 365 days
Filters: Payer, Medical Center, Service Facility, Rendering Provider, Billing Provider
Tiles: Charged, Allowed, Paid, Variance (Underpayment)
Table: "Variance by Payer" or "Variance by Payer Category" with Charged, Allowed, Paid, Variance, and Variance %, sorted with the largest underpayments first

Payments Posted

See what was actually collected in a period, split between insurance and patients. Where Revenue Forecast projects forward and Aging looks at what is still owed, this report is a record of money received.

What it counts: Money received, from two places. Insurance: payments posted to a claim's billing items. Patient: every paid invoice. Anything billed to the patient on an invoice linked to a claim is taken off the insurance side, so it is only counted once.
Date range: A dropdown rather than the usual date fields — Last Month, Last 3 Months, Last 6 Months, Last Year, Year-to-Date, or Custom Range. Choosing "Custom Range" reveals a Start Date and End Date.
Payer groups: Payments are grouped as Commercial, Medicare, Medicaid, Self-Pay, and Other, from the plan type on the patient's primary insurance policy. Patient invoice payments are always counted as Self-Pay.
Tiles: Total Payments, Payment Count, Average Payment, Top Payer
Charts: "Payment Distribution by Payer Group" and "Monthly Payment Trends"
Table: "Payments Summary Analysis" with Payer Group, Total Payments, Payment Count, Adjustments, and Percentage. Click a row with payments in it to open the list of individual payments behind that group.

Aging Reports

Understand outstanding balances and where accounts receivable is getting stuck. The report shows how long the open balance on submitted claims has been outstanding, by payer.

What it counts: Every claim that is not yet "Paid". A claim's balance is its charges minus payments minus adjustments.
Aging Basis: Choose whether to age claims from "Date of service" (default), "Claim created", or "Claim submitted"
Filters: Patient, Rendering Provider, Medical Center, Service Facility, Billing Provider
Tiles: Total Open Balance, Over 90 Days, Over 180 Days, Largest Payer Balance
Chart: "Aging Distribution by Payer Category", one bar per category, stacked by aging bucket. Click a bar to focus the report on that category.
Table: "Aging by Payer Category" or "Aging by Payer", with a column for each bucket (0-30, 31-60, 61-90, 91-120, 121-150, 151-180, and over 180 days) plus a Total. Switch "Cell value" between "Balance" and "Percent of row" to see how much of each payer's balance sits in each bucket. Click any cell to narrow the claims list below to that bucket.
Claims list: "Insurance Claims" at the bottom lists the claims behind the current selection with their date of service, amount, and days aging. Click a row to open the claim.

Revenue Forecast

Project the collections expected over the next twelve months, based on the payments already posted.

What it counts: Payments on remittances marked "Payment Posted" or "Settled", grouped by the month they were received, going back up to 24 complete months
How it is calculated: For each payer — and each procedure worth at least 5% of that payer's payments — Avon fits a trend line, adjusts it for the time of year, and projects twelve months forward. A payer with less than six months of history is projected as a share of the practice total instead. The heading names the method: "Seasonal-trend regression · up to 24 months of history per payer".
Filters: Medical Center, Service Facility, Rendering Provider, Billing Provider. There is no date range; the history window is fixed.
Tiles: Next month's forecast, Next Quarter, Next 12 Months, and the change versus the trailing 12 months of actual payments
Chart: "Collections, actual and projected", with posted payments as a solid line and the forecast as a dashed line
Table: "Forecast by payer" with Trailing 12 mo Collections, Forecast Next 12 mo, Change, Peak Month, and Slowest Month. Switch "Group rows by" to see the same by payer category.

Appointments

Track appointment volume and how reliably appointments are being kept. Providers open the report filtered to their own appointments; everyone else sees the whole organization.

What it counts: Appointments that start inside the date range
Date range: A From and Until date at the top of the page
Filters: Host, Attendee, Appointment Status, and Interaction Type
Tiles: Total Appointments, Completion Rate, Cancellation Rate, No-Show Rate
Charts: Appointments per month, "Appointment Status Distribution", and a breakdown by interaction type
Table: Name, Host, Attendees, Status, Start Time, End Time, and Actions. Click through to open the appointment.
Export CSV: Click "Export CSV" to download the tiles, the distributions, and the appointment list as a spreadsheet

Follow the instructions here to set up appointments.

Form Responses

Track how many forms patients are finishing, which forms stall, and how responses score.

What it counts: Form responses in the date range. One counts as complete when its status is "Completed".
Date range: Shown in the page heading as "DATE RANGE", with the number of responses in scope beneath it
Filters: Form, Patient, Status, and Medical Center
Tiles: Total Responses (with how many are in progress), Completion Rate (with the completed-of-total count), and Avg Score
Charts: Score distribution grouped by form, and response counts by form
Table: Patient, Form, Status, Started At, Completed At, and Score. Members who can complete form responses also get an Actions column.
Export PDF: Click "Export PDF" for a report containing the summary statistics, the date range, the charts, and the full response table — not just the page on screen

Follow the instructions here to send forms to patients, and here for the question types that produce a score.

Course Analytics

See how courses are performing and which patients need outreach.

What it counts: Enrollments and lecture completions. A course's completion rate is the share of enrolled patients who finished it.
Search and filter: Search by course or patient name, and filter to All statuses, Not started, In progress, or Completed
Sort: Courses by completion high to low, completion low to high, enrollment high to low, or name; patients by progress or name
Tiles: Courses (with total enrollments), Patients (enrolled in at least one course), Completion rate (with the number of enrollments completed), and Needs outreach (patients who are enrolled and 0% complete)
Chart: Completion rate by course, as a horizontal bar per course
Needs outreach: A panel listing the enrolled patients who have not started, for follow-up
Course drill-down: Click a course to see its completion rate broken down by week, section, and lecture, and how many of the enrolled patients have completed each one
Patient progress: A table of enrolled patients with lectures completed out of the total

Follow the instructions here to build a course and here to enrol patients.