Members
This report shows all members across all employer groups. It is filterable by:
Type: Subscriber, spouse, dependent
Status: active, inactive, COBRA, pending, annulled
You can also add and remove columns as needed to customize the table.
Claims
This report shows all claims across all employer groups. It is filterable by:
Status: Approved, Denied, Processing
Sponsor: Group Plan Sponsors however you’d like to create sub-groups of claims
Ready to Adjudicate: See which claims are ready to adjudicate, vs ones that require more information (e.g., COB, precert).
Type: Professional, Institutional, Pharmacy, Dental
Network Status: INN and OON
You can also add and remove columns as needed to customize the table.
Aggregated claims reporting also has the Procedure Search feature, which allows users to search by approved procedures on medical claims.
Plan Claims
Plan claims are any medical expenses that are applied to the entire claims fund instead of a specific member. These claims typically come in as itemized invoices instead of traditional claims (a common example is a PBM invoice).
Aggregated Plan Claims are searchable directly in the report, allow users to add and remove columns, and are downloadable directly in the portal as a csv.
Claims Funds
Aggregated Claims funds reporting shows the live balance of every claims fund across your block of business. Claims funds are filterable by Plan Sponsor to create sub-groups, allow users to add and remove columns, and are downloadable directly in the portal as a csv.
Cash Pay
Aggregated cash pay reporting shows a summary of all active cards and their dollar amount, broken down by type. It is filterable by:
Last Used: Never (this allows care navigators to easily locate and cancel unused cards)
Status: Active, Denied, Cancelled, Pending Approval, Limit Change Pending, and Paused
Type: Small case, Recurring, Custom
Priority: Urgent, Immediate
Receipt Status: Complete, Missing
Group (aka Plan Sponsor): Select Plan Sponsors however you’d like to create sub-groups of cash pay cards
Interval: Daily, Weekly, Monthly, All Time, Per Transaction, Yearly
Requester: Me, Others
DPC: Membership, Ancillary allows users who pay DPCs via cash pay card to identify those cards by type quickly and easily
Tags: Care navigators are able to create and manage tags for cash pay cards to support additional custom grouping and filtering
Cash pay card aggregated reporting allows users to add and remove columns, and are downloadable directly in the portal as a csv.
Stoploss Filings
Aggregated stoploss filing reporting gathers all filings from the group level into one place, with the same filters and ability as the stoploss filings page under groups. See more detail about stoploss filing at the group level, see this guide: https://yuzu.health/docs/guides/reports