4.2 Analysis Overview
The Analysis Overview report provides a breakdown of claims activity as well as information on which areas of the plan have the greatest amount of impact on the plan sponsor and member.
Charge Breakdown
The Charge Breakdown is designed to simplify the task of explaining the distribution of responsibility between each of the various payer entities. The pie chart provides a visual depiction of how the total billed charges we adjudicated while the legend area shows actual dollar amounts.
It is important to note that the legend data is hierarchical - each level is the sum of its parts.
Total Charges - The total amount billed by the provider of care, product, or service.
Ineligible - The total amount of ineligible charges due to non coverage, invalid submission, duplicate claims, etc.
Savings - The total amount of savings due to network discounts, coordination of benefits (COB), and reasonable and customary (R&C).
Member Paid - The total amount paid by members in deductible, copay, coinsurance, and non-covered charges.
Plan Paid - The total amount paid by the plan sponsor.
Impact Overview
The Impact Overview provides a glance into the remaining report sections by showing the most costly category or entity for each of the major areas of plan analysis. The Plan Impact table takes the most costly items for the plan sponsor while the Member Impact table takes the most costly items for the member population as a whole.
