What is a Lag Report?
A lag report shows medical claims activity over time, specifically:
When medical care happened
When those claims were paid
A lag report does NOT show:
Premiums or employee funding
Fees (TPA, DPC, Stop-loss, etc)
Eligibility or enrollment timing
Invoicing Schedules
How to Read a Lag Report
Rows (vertical): Month the medical claim was incurred
Columns (horizontal): Month the claim was paid
What do the $ Amounts Represent?
Each number is the total dollar amount of claims:
for services incurred in that row’s month
that were paid in that column’s month
Example: If there is a value in the first column for January, that means members received care in January and those claims were also paid in January.
If a value appears in a later column (e.g., February) on the January row, that means the care happened in January, but the claim wasn’t processed and paid until a later month.