Primary operational indicators - claims report

The report provides aggregate data relating to policies and insurees according to insurance products. The report can be run by users with the system role Manager or with a role including an access to Tools/Reports/Primary Operational Indicators-claims. The table below will provide an overview on primary indicators of the report.
  1. Parameters for selection for the report:
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Img. 243 Image 206 - Primary Operational Indicators - Claims Report Criteria

  1. Input parameters of the report:
  • Month– the period in which a payment takes place
  • Quarter - the period in which a payment takes place
  • Year - the period in which a payment takes place – mandatory
  • Region – region of activity of enrolment officers
  • District - region of activity of enrolment officers
  • Insurance Product – the drop down list with available insurance products for the district according to standard IMIS rules - mandatory
  1. The title of the report
See Input paramaters
  1. Content of the report
  2. Structuring of the report
Tab. 20 Table Overview of operational indicators
Code Primary indicators Dimension Description
P10 Number of claims Time, Health facility, Insurance product The number of claims for given insurance product that emerged during a respective period (Start dateof a claim is within the respective period)
P11 Amount remunerated Time, Health facility, Insurance product Amount remuneratedfor claims for given insurance product that emerged during a respective period (Start dateof a claim is within the respective period)
P12 Number of rejected claims Time, Health facility, Insurance product The number of claims for given insurance product that emerged during a respective period and were rejected (Start dateof a claim is within the respective period and the Status approval ofthe claim is Rejected)
  1. Example
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Img. 244 Image 226 - Preview – Primary Operational Indicators - Claims Report