Interactive Payer Scorecard

Ongoing · the monthly retainer deliverable

Practice A · name withheld · Q1 2026 · prepared by Sandra Stokke

Payer Mix · Procedure Productivity · Service Provider Collections — reconciled. Click through every tab.

Total Collected

$138,232

Across all payers

Charges Billed

$344,611

Gross fee-schedule

Blended Collection Rate

40.1%

Collected ÷ charges

Patients Seen

605

616 policies enrolled

Payer Groups

33 insurers

Collections by Payer Group

Total collected in Q1, largest to smallest

Patient Mix

Share of 605 patients seen (by payer group)

Insurance vs. Patient Share of Collections

Where each group's dollars come from

Collection Rate by Group

Collected ÷ charges billed

Scorecard — click a payer group to expand insurers & case types

Payer Group	Patients	Mix %	Charges	Ins Paid	Pat Paid	Collected	Coll. Rate	Provider A	Provider B
▸ Self-Pay / Wellness	273	45.1%	$86,954	$273	$58,546	$58,819	67.6%	$54,194	$4,442
Insurers: No Policy Defined (Self-Policy) (273) Case types (dollars): Self Pay, Wellness Other Providers: $183
▸ Traditional Medicare	138	22.8%	$106,629	$16,048	$22,793	$38,842	36.4%	$37,645	$1,196
Insurers: MEDICARE PART B (136), AARP Medicare Supplement UHC Claim Division (1), Railroad Medicare (1) Case types (dollars): *Chiro-Medicare, MC, MC/Supp
▸ Medicare Advantage / Replacement	35	5.8%	$49,491	$3,606	$10,899	$14,505	29.3%	$14,058	$421
Insurers: UHC Medicare Advantage (23), AARP Medicare Advantage (7), Network Health MA Plans (2), NETWORK HEALTH (1), UNITED HEALTH CARE MEDICARE ADVANTAGE (1), United Healthcare Medicare Advantage (1) Case types (dollars): MC Replacement, MC/Aetna, UHC MC
▸ Aetna (Commercial)	89	14.7%	$43,502	$2,586	$5,894	$8,481	19.5%	$8,107	$374
Insurers: AETNA (89) Case types (dollars): AETNA
▸ Auto / Personal Injury	6	1.0%	$19,575	$2,999	$4,184	$7,183	36.7%	$7,089	$54
Insurers: GEICO (2), STATE FARM (2), AAA Auto Insurance (1), ALLSTATE (1) Case types (dollars): PI, PI-2
▸ UnitedHealthcare (Commercial)	33	5.5%	$17,126	$1,733	$3,837	$5,570	32.5%	$5,570	$0
Insurers: UHC (25), US Health UHC (4), UnitedHealth Shared Services (2), Golden Rule Insurance Company (1), Surest UnitedHealthcare (1) Case types (dollars): UHC
▸ UMR	16	2.6%	$7,256	$142	$1,622	$1,763	24.3%	$1,763	$0
Insurers: UMR (16) Case types (dollars): UMR
▸ VA / HealthNet	4	0.7%	$2,905	$638	$516	$1,154	39.7%	$1,069	$85
Insurers: VA CCN Optum (4) Case types (dollars): VA/HEALTHNET
▸ BCBS	9	1.5%	$2,406	$297	$316	$612	25.5%	$612	$0
Insurers: BCBS FL (8), BCBS (1) Case types (dollars): BCA, Bcbs
▸ Meritain Health	3	0.5%	$4,276	$313	$86	$399	9.3%	$399	$0
Insurers: Z MERITAIN HEALTH (2), Meritain Health (1) Case types (dollars): Meritain Health
▸ Other TPA / Network	5	0.8%	$2,340	$209	$156	$365	15.6%	$365	$0
Insurers: Alivi Health (1), Allied Benefit Systems (1), GEHA (1), lucent Health (1), UNITED WORLD INS. CO. (1) Case types (dollars): ASH-FB, Cash, ChiroHealth, Cigna, GI, KBA
▸ UHC Optum	4	0.7%	$1,661	$115	$230	$345	20.8%	$345	$0
Insurers: UHC Optum (4) Case types (dollars): UHC Optum
▸ WebTPA	1	0.2%	$490	$0	$193	$193	39.5%	$193	$0
Insurers: WEB TPA (1) Case types (dollars): WebTPA
TOTAL / BLENDED^*	616	101.8%	$344,611	$28,959	$109,273	$138,232	40.1%	$131,411	$6,572

^*Blended = total collected ÷ total charges billed across every payer group combined — not an average of each group's individual rate, but weighted by dollar amount so larger payer groups count for more.

Methodology & Reconciliation

The merge. The three reports share no common key: patient counts exist only by insurance company (33 payers), while dollars exist only by case type (24 buckets). No field links an individual insurer to its dollars, so financials cannot be split below the case-type level. Insurers and case types are therefore both rolled into aligned payer groups — the finest level at which volume and dollars both aggregate truthfully. Expand any row above to see its component insurers and case types.

Reconciliation. Total collected per the Productivity report = $138,232; per the Collections report = $138,166 — a difference of $66 (0.05%), explained by the Productivity report excluding CCP/CRC/MPOT/MIOT payment transactions (stated in its header).

Watch-outs. Case type BCA is grouped with BCBS tentatively (identity uncertain). Cigna and Cash have charges but $0 collected in Q1 and appear only in the Collections report (no patient-mix count). "Patients enrolled" (616) exceeds unique patients seen (605) because some patients carry more than one active policy, so Mix % sums slightly above 100%.

Reading it. Self-Pay/Wellness drives collections ($58,819, 67.6% collection rate — cash pay collects most of what's billed). Commercial insurers show low rates on gross charges because of large contractual write-offs. Provider A accounts for 95.1% of collections, Provider B 4.8%.