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96.5% approval rate across 65 claims •AI Extraction Accuracy: 99.8%
Total Claimed
$7,540.22
65 claims processed
Total Awarded
$7,276.47
96.5% approval rate
Total Shortfall
$263.75
To collect from patients
Claims Analysis
By Provider breakdown
Claimed
Awarded
Shortfall
AI Insights
High Denial Rate Detected
Medical Lab Services has a 83% denial rate for 'Specialized Genetic Screening' claims this month.
Revenue Leakage in Maternity
$42.00 shortfall identified in maternity claims due to 'Benefit Maximum Reached'.
Recovery Opportunity
3 claims marked as 'Duplicate' are potentially recoverable with resubmission.
Claims
65 claims found
| Patient | Provider | Diagnosis | Treatment Date | Claimed | Awarded | Shortfall | Status | ||
|---|---|---|---|---|---|---|---|---|---|
| NEELAN NHIWATIWA | Baines Avenue Clinic | General consultation | 2026-01-15 | $488.28 | $488.28 | $0.00 | Approved | ||
| NEELAN NHIWATIWA | Baines Avenue Clinic | Pharmacy — medication | 2026-01-15 | $162.33 | $162.33 | $0.00 | Approved | ||
| NEELAN NHIWATIWA | Baines Avenue Clinic | Surgical procedure | 2026-01-15 | $160.43 | $160.43 | $0.00 | Approved | ||
| NEELAN NHIWATIWA | Baines Avenue Clinic | Pathology — chemistry panel | 2026-01-15 | $3.50 | $3.00 | $0.50 | Partial | ||
| MISS KUDZAISHE NHIWATIWA | Baines Avenue Clinic | Pharmacy — chronic medication | 2026-01-16 | $25.70 | $25.70 | $0.00 | Approved | ||
| MISS KUDZAISHE NHIWATIWA | Baines Avenue Clinic | Physiotherapy session | 2026-01-16 | $14.00 | $8.00 | $6.00 | Partial | ||
| MR INYASHA MHAKAYAKORA | Baines Avenue Clinic | Extended consultation | 2026-02-06 | $30.22 | $30.22 | $0.00 | Approved | ||
| MR INYASHA MHAKAYAKORA | Baines Avenue Clinic | Pharmacy — medication | 2026-02-06 | $7.58 | $7.58 | $0.00 | Approved |
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