feat: two more finding kinds — single-provider coding, underpayment
The review now cuts by procedure and by provider, and checks paid vs allowed for short-payments. The Run review page lists the checks and the thresholds that apply to each. Co-Authored-By: Claude Fable 5.1 <noreply@anthropic.com>
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@ -199,6 +199,8 @@ export const FINDING_KIND: Record<string, string> = {
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payer_policy: 'Payer rule change',
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front_desk: 'Front-desk / registration',
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coding: 'Coding',
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provider_coding: 'Single provider — coding',
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underpayment: 'Underpayment',
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documentation: 'Documentation',
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medical_necessity: 'Medical necessity',
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timely_filing: 'Timely filing',
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@ -64,12 +64,14 @@ export function RunReviewScreen() {
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<p className="font-semibold text-ink">Checks performed</p>
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<ul className="mt-1.5 list-disc space-y-0.5 pl-4">
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<li>Claims data reconciled against the finance monthly summary</li>
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<li>Denial rate vs 8-week baseline: by payer, reason code, department, front desk, week</li>
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<li>Denial rate vs 8-week baseline: by payer, reason code, department, front desk, week, procedure, provider</li>
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<li>Unfiled appeals with deadlines within 14 days</li>
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<li>Underpayments: paid vs allowed by payer and procedure, vs baseline</li>
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</ul>
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<p className="mt-2 text-xs text-faint">
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Materiality threshold: denied count up more than 40% on at least 25 claims, or more
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than $100K in appeals expiring. Items below the threshold are listed, not flagged.
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Materiality threshold: denied count up more than 40% on at least 25 claims; more than
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$100K in appeals expiring; or paid/allowed down more than 10 points or a $50K shortfall.
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Items below the threshold are listed, not flagged.
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</p>
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<p className="mt-2 inline-flex items-center gap-1.5 text-xs text-faint">
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<Database className="h-3.5 w-3.5" />
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