From de86cd98598bb2e4730f5448a91ef6f3a251e685 Mon Sep 17 00:00:00 2001 From: Yashas Date: Wed, 16 Sep 2026 16:16:58 +0530 Subject: [PATCH] feat: slow-payer and appeal-scorecard checks on the Run review page Co-Authored-By: Claude Fable 5.1 --- src/api/config.ts | 1 + src/screens/RunReviewScreen.tsx | 5 ++++- 2 files changed, 5 insertions(+), 1 deletion(-) diff --git a/src/api/config.ts b/src/api/config.ts index ef00dd8..a9ad2da 100644 --- a/src/api/config.ts +++ b/src/api/config.ts @@ -201,6 +201,7 @@ export const FINDING_KIND: Record = { coding: 'Coding', provider_coding: 'Single provider — coding', underpayment: 'Underpayment', + slow_payer: 'Slow payer', documentation: 'Documentation', medical_necessity: 'Medical necessity', timely_filing: 'Timely filing', diff --git a/src/screens/RunReviewScreen.tsx b/src/screens/RunReviewScreen.tsx index 513b5c4..f63ee3e 100644 --- a/src/screens/RunReviewScreen.tsx +++ b/src/screens/RunReviewScreen.tsx @@ -67,10 +67,13 @@ export function RunReviewScreen() {
  • Denial rate vs 8-week baseline: by payer, reason code, department, front desk, week, procedure, provider
  • Unfiled appeals with deadlines within 14 days
  • Underpayments: paid vs allowed by payer and procedure, vs baseline
  • +
  • Slow payers: claims sent 31–60 days ago still unanswered, by payer
  • +
  • Appeal scorecard: overturn rate by payer, used to size recoveries and order appeal work
  • Materiality threshold: denied count up more than 40% on at least 25 claims; more than - $100K in appeals expiring; or paid/allowed down more than 10 points or a $50K shortfall. + $100K in appeals expiring; paid/allowed down more than 10 points or a $50K shortfall; + or more than a quarter of a payer's month-old claims still unanswered, worth over $250K. Items below the threshold are listed, not flagged.