RCM Intelligent Systems

Daniel Rejection Analytics

Strategic Revenue Cycle Management Dashboard • FY 2025

Recovery Rate

74.2%

+12.4%

Gross Claims Value

2,840,000 sar

+3.2%

Total Denial Value

564,210 sar

+15.8%

Net Cash Inflow

2,275,790 sar

-1.8%

Denial Percentage

19.8%

Revenue Leakage vs. Recovery

12-Month Performance Trend (Jan - Dec)

Collected
Denied

Denial Root-Cause Analysis

Segmentation by Claim Rejection Reason

Detailed Claims Log

Live Sync
Payer Service Dept Rejection Reason Value (SAR) Status
Tawuniya Emergency (ER) Invalid Medical Code 45,120.00 Appealing
Bupa Arabia Inpatient (IPD) Pre-Auth Missing 112,400.00 Under Review
Medgulf Radiology Duplicate Service 8,950.00 Recovered
AXA / GIG Outpatient (OPD) Not Covered 14,200.00 Closed

AI Strategic Insights

Critical Leakage

Medical coding errors in Emergency Department account for 42% of total denials. Urgent staff re-certification is recommended to prevent FY25 losses.

Collection Optimization

Bupa Arabia recovery rate improved by 18.5% following the new pre-authorization gatekeep protocol.

Payer Behavior

Medgulf is exhibiting a trend of "Duplicate Service" rejections in Radiology. Recommend reviewing clinical data mapping.

RCM Team Collection Efficiency 88.5%

Daniel Intelligent Analytics Engine • Version 4.0.2