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. 248 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. 9 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. 249 Image 226 - Preview – Primary Operational Indicators - Claims Report