# Reports¶

Access to the reports is generally restricted to the users with the role of Manager, Accountant, Scheme Administrator and openIMIS Administrator. By having access to the Reports Page, it is possible to generate several operational reports. Each report can be generated by users with a specific system role (Manager, Accountant, Scheme Administrator and IMIS Administrator) only or with a role including an access to Tools/Reports.

## Report Preview¶

The report viewer offers the facility to navigate through the report either by using the arrows or by typing in a page number at the top of the report. Another feature of the report viewer is to export the report in different formats. Currently system supports three formats; Word, Excel and PDF. Select the desired format from the list by clicking on the Export link. Use the Go Back to Selector link to go back to the previous selection page.

Below are the types of reports as they can be seen in the report page.

1. primary operational indicators - policies 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-policies. The table below will provide an overview on primary indicators of the report.

Tab. 22 Table Overview of Policies indicators
Code Primary indicators Dimension Description
P1 Number of policies Time, Insurance product The number of policies of given insurance product on the last day of a respective period (Status of the policy is Active, the last day of period is within <Effective date, Expiry day>)
P2 Number of new policies Time, Insurance product The number of new policies of given insurance product during a respective period (Enrolment date is within the respective period, there is no preceding policy with the same (or before converted) insurance product forgiven policy)
P3 Number of suspended policies Time, Insurance product The number of policies for given insurance product that were suspended during a respective period (Status of the policy is Suspended, suspension took place within the respective period)
P4 Number of expired policies Time, Insurance product The number of policies for given insurance product that expired during a respective period (Status of the policy is Expired,expiration took place within the respective period)
P5 Number of renewals Time, Insurance product The number of policies that were renewed forgiven insurance product (or a converte done) during a respective period ( Enrolment date is within the respective period, there is a preceding policy with the same (or before converted) product forgiven
P6 Number of insurees Time, Insurance product The number of insurees covered by policies of given insurance product on the last day of a respective period (An insuree belongs to a family with an active coverage on the last day of the respective period-see P1 )
P7 Number of newly insured insurees Time, Insurance product The number of insurees covered by new policies of given insurance product during a respective period (An insuree belongs to a family with newly acquired policy during the respective period-see P2 )
P8 Newly collected Contributions Time, Insurance product Amount of acquired Contributions (for policies of given insurance product) during a respective period ( Date of payment of a Contribution is within the respective period)
P9 Available Contributions Time, Insurance product Amount of Contributions that should be allocated for policies of given insurance product for a respective period provided a uniform distribution throughout the insurance period takes place. (If the respective period overlaps with <Effective date, Expiry day> of a policy then a proportional part of corresponding Contributions relating to the respective period is included in available Contributions)

Below is an example of the report:

Img. 246 Preview – Primary Operational Indicators - Policies Report

2. 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.

Tab. 23 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)

Below is an example of the report:

Img. 247 Preview – Primary Operational Indicators - Claims Report

3. derived operational indicators report

The report provides operational indicators derived from primary operational indicators. The report can be run by users with the system role Manager or with a role including an access to Tools/Reports/Derived Operational Indicators. The table below will provide an overview on the actual derived indicators provided by the report.

Tab. 24 Table Overview of derived operational indicators
Code Derived Dimension Description
D1 Incurred claims ratio Time, Insurance product It is the ratio P11/P9
D2 Renewal ratio Time, Insurance product It is the ratio P5/P4
D3 Growth ratio Time, Insurance product It is the ratio P2/P1-for immediately preceding period
D4 Promptness of claims settlement Time, Insurance product It is the average (date of sending to payment- Date of submission of the claim) for all claims relating to given insurance product and emerging in a respective period Date of sending of payment is not in the structure of Claim, it has to be retrieved from a journal-can be?)
D5 Claims settlement ratio Time, Health facility, Insurance product It is the ratio (P10-P12)/P10
D6 Number of claims per insuree Time, Insurance product It is the ratio P10/P6
D7 Average cost per claim Time, Health facility, Insurance product It is the ratio P11/P10
D8 Satisfaction level TimeDistrict, Health facility The average mark from feedbacks received in a respective period
D9 Feedback response ratio Time, District, Health facility The ratio of number of feedbacks received (up to time of creation of the report) and number of feedbacks asked for in a respective period

Below is an example of the report:

Img. 248 Preview – Derived Operational Indicators Report

4. Contribution collection report

The report lists all actual payments of contributions according to insurance products in the defined period. The report can be used as input to an accounting system. The report can be run by users with the the system role Accountant or with a role including an access to Tools/Reports/Contribution Collection. Payments are assigned to the specified period according to the actual date of payment. (Img. 249)

Img. 249 Preview – Contribution Collection Report

5. product sales report

The report provides overview of selling of policies according to insurance products in terms of calculated contributions (not necessarily actually paid). The report can be run by users with the system role Accountant or with a role including an access to Tools/Reports/Product Sales. Policies are assigned to the specified period according to their effective days. (Img. 250)

Img. 250 Preview – Product Sales Report

6. Contribution distribution report

The report provides proportional amount of actually paid contributions allocated by openIMIS to specific months according to insurance products. The report can be run by users with the system role Accountant or with a role including an access to Tools/Reports/Contribution Distribution. This report shows the information about the Total collection, Allocated amount and Not allocated amount for contributions in the specified period.

Allocated amount is the proportionally calculated amounts of contributions paid covering the month. Not Allocated amount is the amount collected for contributions that have a start date in the future (after the month in question). (Img. 251)

Img. 251 Preview – Contribution Distribution Report

7. user activity report

The report shows activities of users according to types of activities and types of entities to which the activities relate. The report can be run by users with system role IMIS Administrator or with a role including an access to Tools/Reports/User Activity. (Img. 252)

Img. 252 Preview – User Activity Report

8. enrolment performance indicator report

The report provides overview of activity of enrolment officers. The report can be run by users with the system role Manager or with a role including an access to Tools/Reports/Enrolment Performance Indicator. (Img. 253)

Img. 253 Preview – Enrolment Performance Indicator Report

9. status of registers report

The report provides an overview of the number of items in registers according to districts. The report can be run by users with the system role Scheme Administrator or with a role including an access to Tools/Reports/Status of Registers.(Img. 254)

Img. 254 Preview – Status of Registers Report

10. insurees without photos

The report lists all insurees according to enrolment officers that have not assigned a photo. The report can be run by users with thesystem role Accountant or with a role including an access to Tools/Reports/Insurees without Photos. (Img. 255)

Img. 255 Preview – Insurees without photos

11. matching funds

The report lists all families/groups according to insurance products and (institutional) payers that paid contributions in the specified period. This report is useful for claiming of subsidies for running of health insurance schemes. The report can be run by users with the system role Accountant or with a role including an access to Tools/Reports/Matching Funds. (Img. 256)

Img. 256 Preview –Matching Funds

12. claim overview

The report provides detailed data about results of processing of claims in openIMIS according to insurance products and health facilities. The report can be used as a tool for communication between a health insurance scheme and its contractual health facilities. The report can be run by users with the rsystem role Accountant or with a role including an access to Tools/Reports/Claim Overview. Claims are assigned to the specified period according to date of provision of health care (in case of in-patient care according to the date of discharge). (Img. 257)

Img. 257 Image 236 Preview – Claim Overview

13. payment category overview

The report provides split of total contributions according to their categories. The report can be run by users with the system role Accountant or with a role including an access to Tools/Reports/Payment Category Overview. Contributions are assigned to the specified period according to actual payment date. (Img. 258)

Img. 258 Preview – Payment Category Overview

14. Families and Insurees Overview report

The report provides an overview of enrolled families/groups and their members in specified location within the specified period. The report can be run by users with the system role Accountant or with a role including an access to Tools/Reports/Families and Insurees Overview. (Img. 259)

Img. 259 Preview – Families and Insurees Overview Report

15. Percentage of Referrals report

The report lists all primary health care facilities (the category is Dispensary and Health Centre) in the selected district and for each such health facilities provides the following indicators:

1. The number of visits (claims) of the primary health care facility in the selected period.
2. The number of out-patient visits that have Visit Type equal to Referral in all other health facilities (irrespective of the district) for insurees with the First Service Point in the respective primary health care facility.
3. The number of in-patient stays that have Visit Type equal to Referral in all health facilities-hospitals (irrespective of the district) for insurees with the First Service Point in the respective primary health care facility.

The report can be run by users with the system role Accountant or with a role including an access to Tools/Reports/Percentage of Referrals. (Img. 260)

Img. 260 Preview – Percentage of Referrals Overview Report

16. Pending Insurees report

The report lists all insurees whose photos have been sent to openIMIS but who has no record in openIMIS yet. The report can be run by users with the system role Accountant or with a role including an access to Tools/Reports/Pending Insurees. (Img. 261)

Img. 261 Preview – Pending Insurees Report

17. Renewals report

The report lists all renewed policies in given period for given insurance product and optionally for given enrolment officer. The families that have at least one payment of contributions in given period of time are included in the report. The report can be run by users with the system role Accountant or with a role including an access to Tools/Reports/Renewals. Below is an example of the report (Img. 262)

Img. 262 Preview – Renewals Report

18. Capitation Payment Report

The report lists capitation payments for all health facilities specified in the capitation formula for specified month and for given insurance product. The report can be run by users with the system role Accountant or with a role including an access to Tools/Reports/Capitation Payment. (Img. 263)

Img. 263 Preview –Capitation Payment Report