Heron

Revenue Cycle Overview

Northside Medical · August 2026 · $729,339 in A/R

Live · synced 2m ago
Total A/R
$0
24.9% over 90 days
Days in A/R
0d
target < 40d
Denial Rate
0.0%
target < 10%
Net Collection Rate
0.0%
target > 95%
Revenue at Riskwhere money is leaking
Open Denials
$996,074
awaiting appeal or review
Underpaid
$19,374
below contracted rates
A/R Over 90 Days
$181,683
24.9% of total A/R
Timely Filing Risk
30 claims
deadline within 30 days
A/R Trend
Rolling 12 months · hover a month for detail
$729,339
-15.0% vs Sep
SepOctNovDecJanFebMarAprMayJunJulAug
Total A/ROver 90 days28d in A/R
Expected Collectionsprobability weighted
Next 30 days$300,787
across 89 open claims
Next 60 days$382,350
across 114 open claims
Next 90 days$420,610
across 129 open claims
Recovered to date$208,068
A/R Agingby days outstanding
$367K
0-30d · 89
$115K
31-60d · 25
$66K
61-90d · 15
$89K
91-120d · 17
$92K
120+d · 23
A/R by Payer
Outstanding balance, split by age
Work queue →
UnitedHealthcare · 49 claims$179,292
28.8% over 90 days · escalate
BCBS · 32 claims$177,960
20.7% over 90 days
Aetna · 33 claims$120,573
12.6% over 90 days
Medicaid · 13 claims$99,883
49.6% over 90 days · escalate
Medicare · 18 claims$66,755
30% over 90 days · escalate
Cigna · 19 claims$60,579
10.2% over 90 days
Humana · 5 claims$24,297
9.6% over 90 days
0-30d31-60d61-90d91-120d120+d
Denial Outcomes
Where denied dollars end up
77%
win rate on settled
Denied · 197$1,233,861
In queue · 73$483,300
Under appeal · 66$512,774
Recovered · 44$183,901
Written off · 14$53,886
$183,901 recovered against $53,886 written off. Everything still in queue or under appeal is money the outcome is not decided on yet.
Priority Worklistacross all queues
Denial
Jennifer Walsh · Aetna
Appeal window lapsed 134d ago · Pre-Auth Missing
$42,000
CLM-2024-8733
Denial
James Okafor · UnitedHealthcare
Appeal window lapsed 100d ago · Pre-Auth Missing
$38,200
CLM-2024-8831
Denial
Patricia Chen · BCBS
Appeal window lapsed 107d ago · Bundling/Coding Error
$29,100
CLM-2024-8819
Denial
Catherine Yang · UnitedHealthcare
Appeal window lapsed 114d ago · Medical Necessity
$27,500
CLM-2024-8628
Denial
Carlos Rivera · Cigna
Appeal window lapsed 147d ago · Pre-Auth Missing
$25,600
CLM-2024-8695
Denial
Lisa Washington · Aetna
Appeal window lapsed 110d ago · Medical Necessity
$21,000
CLM-2024-8620
A/R
Emily Jones · UnitedHealthcare
Timely filing lapses today
$19,165
CLM-2026-5073
Denial
Susan Park · BCBS
Appeal window lapsed 144d ago · Medical Necessity
$18,500
CLM-2024-8701
Denial Rate by Payer
Medicare
14%
Aetna
12%
Humana
12%
UnitedHealthcare
11%
Cigna
10%
BCBS
9%
Medicaid
6%
Top Denial Reasons · Last 90 Days
Medical Necessity
53
Pre-Auth Missing
25
Bundling/Coding Error
17
Missing Information
17
Not Covered
10