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MedveriCodex

Analytics & Reports

Revenue cycle analytics, coding patterns, and optimization opportunities.

88

Monthly Encounters

$38,200

Monthly Revenue

$434

Avg $/Encounter

4.2%

Denial Rate

68%

Appeal Win Rate

94.3%

Compliance Avg

Revenue Trend

Last 6 months
$42.8k
Sep98 enc
$48.2k
Oct112 enc
$51.4k
Nov119 enc
$44.1k
Dec95 enc
$55.8k
Jan128 enc
$38.2k
Feb88 enc

Denial Rate Trend

Denial rate decreased from 9.2% to 4.2% since adopting MedveriCodex

-54% reduction
9.2%
Sep
7.8%
Oct
6.5%
Nov
5.9%
Dec
4.7%
Jan
4.2%
Feb

E/M Code Distribution

This month

14 encounters may support higher E/M level — $4,200 potential recovery.

99211 — Minimal4 (4.5%)
99212 — Straightforward8 (9.1%)
99213 — Low26 (29.5%)
99214 — Moderate34 (38.6%)
99215 — High12 (13.6%)
99205 — New, High4 (4.5%)

Payer Denial Comparison

Last 90 days

Denial rate and average days to payment by insurer.

Medicare Part B

4.8% denial rate
42 claims2 deniedAvg 18d to pay

Blue Cross Blue Shield

7.1% denial rate
28 claims2 deniedAvg 24d to pay

Aetna

9.1% denial rate
22 claims2 deniedAvg 31d to pay

UnitedHealthcare

11.1% denial rate
18 claims2 deniedAvg 28d to pay

Revenue Optimization

Monthly report

E/M undercoding analysis, modifier optimization, and add-on recovery.

Undercoding Opportunities

Encounters that may support higher E/M levels

14

encounters

Potential Revenue Recovery

Estimated value of undercoding corrections

$4,200

estimated

HCC Gap Analysis

Monthly report

Medicare Advantage risk adjustment gaps and RAF weight recapture.

3

Open Gaps

0.897

Potential RAF

Karen TaylorHCC 40

Rheumatoid Arthritis and Inflammatory Connective Tissue Disease

Open

Thomas BrownHCC 72

Polyneuropathy

Open

Dorothy WilsonHCC 59

Major Depressive, Bipolar, and Paranoid Disorders

Queried

Robert JohnsonHCC 40

Rheumatoid Arthritis and Inflammatory Connective Tissue Disease

Recaptured

Top Denial Reasons

Monthly report

Root cause analysis of denied claims by category.

Bundling (CO-97)2 (25%)
Modifier Missing (CO-4)2 (25%)
Medical Necessity (CO-50)2 (25%)
Coding Error (CO-11)1 (12.5%)
Timely Filing (CO-29)1 (12.5%)

Predictive Revenue Forecast

Weekly report

90-day forecasting with what-if scenarios and anomaly detection.

Mar 2026

Confidence: High

$58,200

Apr 2026

Confidence: Medium

$61,400

May 2026

Confidence: Low

$63,100