Claims Dashboard

Real-time claims pipeline overview — April 2026

New Claim EDI Upload Audit Rules Dispute Fraud Detection

1,247

Submitted

↑ 8.2% vs last month

389

Pending Review

↑ 4.1% vs last month

743

Adjudicated

↑ 12.5% vs last month

$2.1M

Total Paid

↑ 6.8% vs last month

115

Denied

↓ 2.3% vs last month

Claims Volume — 12 Months

Monthly submitted vs adjudicated claims

Submitted Adjudicated

Processing Metrics

Current period performance

Avg Days to Adjudication 4.2

↓ 0.8 days from target (5.0)

Auto-Adjudication Rate 73.4%

↑ 5.2% from last month

Denial Rate 9.2%

↓ 1.1% improvement

Clean Claim Rate 87.3%

↑ 3.4% from last month

Recent Claims

View All

Claim ID	Patient	Provider	Type	Amount	Status	Date	Actions
CLM-2026-04721	Maria Gonzalez MRN: 482910	Dr. Robert Chen NPI: 1234567890	Professional	$1,240.00	Pending	Apr 1, 2026
CLM-2026-04720	James Wilson MRN: 391847	Memorial Hospital NPI: 9876543210	Institutional	$18,450.00	Paid	Apr 1, 2026
CLM-2026-04719	Susan Parker MRN: 574823	Dr. Amanda Lee NPI: 2345678901	Professional	$320.00	Denied	Mar 31, 2026
CLM-2026-04718	Thomas Brown MRN: 682930	City Dental Associates NPI: 3456789012	Dental	$890.00	Adjudicated	Mar 31, 2026
CLM-2026-04717	Linda Martinez MRN: 294857	Riverside Medical Ctr NPI: 4567890123	Institutional	$42,300.00	Pending	Mar 30, 2026
CLM-2026-04716	Kevin Johnson MRN: 847291	Dr. Patricia Wood NPI: 5678901234	Professional	$680.00	Paid	Mar 30, 2026
CLM-2026-04715	Nancy Adams MRN: 391920	Dr. Michael Torres NPI: 6789012345	Professional	$215.00	Adjudicated	Mar 29, 2026

Showing 7 of 1,247 claims

AI Assistant

The Claims Dashboard provides a real-time overview of your entire claims pipeline. Use the stat cards at the top to quickly assess claim volumes and financial performance.

Click any stat card to drill into that category
Use Quick Links for common actions like New Claim or EDI Upload
The date selector filters all widgets to the selected period

The five pipeline cards track claim lifecycle stages:

Submitted — Claims received, awaiting processing
Pending — In review, missing information, or requiring manual intervention
Adjudicated — Processed with a payment decision made
Paid — Total dollar amount of approved payments
Denied — Claims with a denial decision

Key performance indicators on the right panel:

Avg Days to Adjudication — Target is ≤5 days. Lower is better.
Auto-Adjudication Rate — Higher % means less manual work. Target ≥70%.
Denial Rate — Industry benchmark is ≤10%. Monitor trends carefully.
Clean Claim Rate — Claims processed without rework. Target ≥90%.

The recent claims table shows the latest activity:

Review — Open pending claims for adjudication workflow
Appeal — Initiate a formal dispute for denied claims
View — Read-only view of completed claims with full audit trail

Use the search bar to filter by Claim ID, patient name, or provider.