# Healthcare RCM Analytics: Denials, AR Aging and SLAs

> Ask claims and billing data about denials by payer, AR by aging bucket, days to bill and client SLAs, then keep watch over them. HIPAA BAA available.

HTML version: https://supaboard.ai/industry/revenue-cycle-management

**Know which claims are slipping before they age.** Connect your claims, billing and appointment data, then ask in plain English: denials by payer, AR by aging bucket, days to bill, every client's SLA. Supaboard keeps watch after you've asked.

For revenue-cycle service companies, provider billing teams, and practice-management and EHR vendors.

## Every question, by who asks it

### Denials

- Denial rate by payer last month, and the CARC codes behind it
- Denials still not worked after 14 days
- Clean claim rate this week against last, and which edits fail most
- The CPT codes with the highest denial rate at Medicare Advantage, last 90 days

### AR and collections

- Insurance AR by aging bucket for each payer
- AR over 120 days, Medicare against commercial, since January
- Net collection rate by client this quarter: who is under 95%?

### Billing speed and SLAs

- Average days from date of service to submission, by client
- Unbilled claims within 30 days of the payer's filing limit
- Did we hit the 48-hour claim-out SLA for each client last week?

## Keep it running

- **One SLA pack per client** (Monday 07:00). Every client gets last week's claim-out rate, denials and aging as a PDF in their inbox before the Monday call. Automation: Timed Start → Query Your Data → Summarize Insights → Send Email.
- **Denial spike watch** (Every 5 minutes). A SQL check compares each payer's denial rate today with its 30-day average and emails the denials lead when one jumps. Automation: Alerts → Send Email.
- **Each client's own datasite** (Month end). A private datasite per client, with Google or Microsoft sign-in, so the practice sees its numbers without a login to your systems.

## The numbers it keeps watch on

| Measure | Definition | Source | In Supaboard |
| --- | --- | --- | --- |
| Clean claim rate | Claims that pass edits with no manual touch ÷ claims sent to the scrubber | HFMA MAP Keys CL-1 | Weekly report, per client |
| Denial rate | Claims with an actionable denial on the 835 ÷ claims remitted | HFMA MAP Keys AR-5 | Alert when a payer jumps |
| Aged AR | Insurance AR by bucket from date of service, per payer group | HFMA MAP Keys AR-1 to AR-4 | Dashboard on live data |
| Net days in AR | Net AR ÷ average daily net patient service revenue | HFMA MAP Keys FM-1 | Monthly SLA pack |
| Days to bill | Date of service to claim submission | Your client SLA | A rule, then a weekly report |
| Net collection rate | Payments ÷ (charges − contractual adjustments) | Common practice | Each client's datasite |
| Cost to collect | Revenue-cycle cost ÷ patient cash collected | HFMA MAP Keys FM-6 | Ask it each quarter |

## Where your data lives

- [Snowflake](https://supaboard.ai/integrations/snowflake): connects live
- [SQL Server](https://supaboard.ai/integrations/ms-sql-server): connects live
- [Postgres](https://supaboard.ai/integrations/postgresql): connects live
- Oracle: connects live

Or attach an export to a conversation, as CSV or Excel: Claim and remittance exports.

The tables these questions read: Claim header and claim lines, with CPT, ICD-10, provider and location; 835 remittance and adjustment lines, with CARC and RARC codes; 999 and 277CA acknowledgements; Appointments and encounters; A payer-group map.

## Teach it your definitions once

Rules are read with every question, so a term means the same thing in Chat, in Slack and in the Monday report.

- Rule: "Denial rate counts claims, not lines, and only payer denials on the 835."
- Rule: "Aging starts at date of service, not at submission."
- Rule: "Commercial means every payer group except Medicare, Medicare Advantage and Medicaid."

[How rules work](https://supaboard.ai/product/knowledge-and-rules)

## Already running on it

A revenue-cycle company runs Supaboard on each client's claims data in Snowflake. Its teams ask about denials, insurance AR by aging bucket, SLAs, collections and the lag from service to submission. (A Supaboard customer, described without its name.)

- **90%** lower analysis cost for a revenue-cycle provider
- **4 hours → 2 minutes** from question to answer

## Security

- **HIPAA BAA.** Available on Enterprise. Sign it before patient data goes into Supaboard.
- **Read-only by construction.** Database and warehouse queries are read-only. We give you the SQL for a read-only user too.
- **Your own VPC, if you need it.** On Enterprise, Supaboard runs as single-tenant containers in your environment, on your own model keys.
- **Your data region.** North America, EU or Asia, chosen when the workspace is created.

## FAQ

### Will Supaboard sign a BAA?

Yes. A HIPAA BAA is available on Enterprise. If protected health information is in scope, sign it before that data goes into Supaboard.

### Can each client get its own reports?

Yes. Give each client a private datasite with Google or Microsoft sign-in, and email each one its own SLA pack on its own schedule. You can also keep one workspace per client.

### Can it change anything in our billing system?

No. Database and warehouse queries are read-only. We give you the SQL to create a read-only user.

### How does it learn our definition of a denial or of aging?

Write it once as a rule, such as "aging starts at date of service". The agent reads its rules with every question, and you can save reviewed SQL as examples.

### What kinds of questions is it built for?

Revenue-cycle, operational and financial questions about data your organisation already holds: claims, remittances, AR, collections and SLAs.

## More in Healthcare & Life Sciences

- [Medical & Dental Practices](https://supaboard.ai/industry/medical-practices): Schedule fill, no-shows, production by provider and collections, from your practice system.
- [Senior Care & Staffing](https://supaboard.ai/industry/senior-care): Authorised hours, missed visits, overtime and open shifts, from scheduling and payroll data.
- [Pharmacies](https://supaboard.ai/industry/pharmacies): Scripts, margin by payer, stock and refills, from your pharmacy system's data.

Supaboard is [the AI data analyst connected to your business data](https://supaboard.ai/). For the background on this industry, read [AI predictive analytics in healthcare: a practical guide](https://supaboard.ai/blog/healthcare-analytics). [All industries](https://supaboard.ai/industry).

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