reports.rst

Reports

Access to the reports is generally restricted to the users with the role of Manager, Accountant, Scheme Administrator and openIMIS Administrator. By having access to the Reports Page, it is possible to generate several operational reports. Each report can be generated by users with a specific system role (Manager, Accountant, Scheme Administrator and IMIS Administrator) only or with a role including an access to Tools/Reports.

Pre-Conditions

Navigation

All functionality for use with the administration of Reports can be found under the main menu Tools, sub menu Reports.

Navigation Reports

Clicking on the sub menu Reports re-directs the current user to the Reports Page (image204).

Reports Page

The Reports Page is divided into four panels (image204).

1. Select Criteria

   The Select Criteria panel or the filter panel allows a user to select specific criteria determining the scope of data included in the report. The criteria (image205 – image222) will change depending on the selected type of the report.

   • Primary Operational Indicators - Policies Report.

   Primary Operational Indicators - Policies Report Criteria

   • Primary Operational Indicators - Claims Report.

   Primary Operational Indicators - Claims Report Criteria

   • Derived Operational Indicators Report.

   Derived Operational Indicators Report Criteria

   • Contribution Collection Report.

   Contribution Collection Report Criteria

   • Product Sales Report.

   Product Sales Report Criteria

   • Contribution Distribution Report.

   Contribution Distribution Report Criteria

   • User Activity Report.

   User Activity Report Criteria

   • Enrolment Performance Indicator Report.

   Enrolment Performance Indicators Report Criteria

   • Status of Registers Report.

   Status of Registers Report Criteria

   • Insurees without Photos Report.

   Insurees without photos Report Criteria

   • Payment Category Overview Report.

   Payment Category Overview Report Criteria

   • Matching Funds Report.

   Matching funds Report Criteria

   • Claim Overview Report.

   Claim Overview Report Criteria

   • Percentage of Referrals Report.

   Percentage of Referrals Report Criteria

   • Families and Insurees Overview Report.

   Families and Insurees Overview Report Criteria

   • Pending Insurees Report.

   Pending Insurees Report Criteria

   • Renewals Report.

   Image 221 Renewals Report Criteria

   • Capitation Payment Report

   Image 222 Capitation Payment Report Criteria

The general meaning of selection criteria for creating of a report is as follows:

• Date From

  Type in a date; or use the Date Selector Button, to enter the beginning of a period, in which policies have their enrolment, effective, expire or renewal days, contributions were paid or in claimed health care was provided. If used with a report, it is mandatory. Note. To clear the date entry box; use the mouse to highlight the full date and then press the space key.

• Date To

  Type in a date; or use the Date Selector Button, to enter the end of a period, in which policies have their enrolment, effective, expire or renewal days or in which claimed health care was provided. If used with a report, it is mandatory. Note. To clear the date entry box; use the mouse to highlight the full date and then press the space key.

• Payment Type

  Select the Payment Type from the drop down list by clicking on the right arrow. By selecting any of the options a user can filter the report on a particular type of the payment. This filter is not mandatory, leave it blank to preview the report on all the payment modes.

• Region

  Select the Region; from the list of regions by clicking on the arrow on the right of the selector to select a region, data of which should be included for the report. Note: The list will only be filled with the regions assigned to the current logged in user. If this is only one then the region will be automatically selected.

• District

  Select the District; from the list of districts by clicking on the arrow on the right of the selector to select a district, data of which should be included for the report. Note: The list will only be filled with the districts belonging to the selected region and assigned to the current logged in user. If this is only one then the district will be automatically selected.

• Product

  Select the Product; from the list of products by clicking on the arrow on the right of the selector to include in the report data for the specific product. Note: The list will only be filled with the products belong to the districts assigned to the current logged in user. If this is only one then the product will be automatically selected.

• Month

  Select the Month from the list of months by clicking on the arrow on the right of the selector to include in the report data relating to that month selected.

• Year

  Select the year from the list of years by clicking on the arrow on the right of the selector to include in the report data relating to that year selected.

• Quarter

  Select the quarter from the list of quarters by clicking on the arrow on the right of the selector to include in the report data relating to that quarter selected.

• HF Code

  Select the HF Code; from the list of heath facility codes by clicking on the arrow on the right of the selector to create the report for the specific health facility. Note: The list will only be filled with health facility codes of health facilities belonging to the districts assigned to the current logged in user. If this is only one then the health facility code will be automatically selected.

• Enrolment Officer

  Select the enrolment officer; from the list of enrolment officers by clicking on the arrow on the right of the selector to select enrolment officer data of whom should be included in the report. Note: The list will only be filled with the enrolment officers assigned to the current selected district. If this is no district selected the enrolment officers list will be filled by all districts' enrolment officers

• Payer

  Select the payer from the drop down list by clicking on the right arrow. By selecting any of the options a user can filter the report on a particular payer. This filter is not mandatory; leave it blank to preview the report on all the payers.

• Claim Status

  Select the claim status from the drop down list by clicking on the right arrow. By selecting any of the options a user can filter the report on a particular claim status. This filter is not mandatory, leave it blank to preview the report on all the claim statuses.

• Sorting

  Select the way of sorting of records in the report from the list of available ways of sorting (Renewal Date, Receipt Number, Enrolment Officer).

• Previous

  Select the previous reports from the drop down list by clicking on the right arrow. By selecting any of the options a user can fetch a report which was produced before. Note: This filter is available only for Matching Funds Report.

• CONTROL NO.

  Enter a control number to get a payment corresponding to the entered control number. This filter is not mandatory. Note: This filter is available only for Contribution Payment Report.

• PAYMENT STATUS

  Select either Matched or Unmatched as the payment status. Note: This filter is available only for Contribution Payment Report.

• POSTING STATUS

  Select the status of posting of requests for control numbers. This filter is not mandatory. Note: This filter is available only for Control Number Assignment.

• ASSIGNMENT STATUS

  Select the status of results of requests for control number. This filter is not mandatory. Note: This filter is available only Control Number Assignment Report.

• INSURANCE NUMBER

  Enter the insurance number of an insuree. This filter is not mandatory. Note: This filter is available only Claim History Report.

• MODE

Select the mode (Prescribed Contributions, Actually Paid Contributions) of calculation of commissions. This filter is mandatory. Note: This filter is available only Overview of Commissions.

• COMMISSION RATE

Enter a commission rate as % of an assessment base. This filter is mandatory. Note: This filter is available only Overview of Commissions

• Date Selector Button

  Clicking on the Date Selector Button will pop-up an easy to use, calendar selector (image223) by default the calendar will show the current month, or the month of the currently selected date, with the current day highlighted.

  • At anytime during the use of the pop-up, the user can see the date of today.
  • Clicking on today will close the pop-up and display the today’s date in the corresponding date entry box.
  • Clicking on any day of the month will close the pop-up and display the date selected in the corresponding date entry box.
  • Clicking on the arrow to the left displays the previous month.
  • Clicking on the arrow on the right will displays the following month.
  • Clicking on the month will display all the months for the year.
  • Clicking on the year will display a year selector.

  +----------++----------++----------+ | || || | +----------++----------++----------+

  Calendar Selector - Search Panel

1. Report Type Selector

   This panel contains a list of available report types. A user can select to create a desired report by clicking on the report type list item (image224) and narrow the report using the criteria being shown on the panel above, and then click the preview button to create the report. Available report types are:

   • Primary Operational Indicators Report.
   • Derived Operational Indicators Report.
   • Contribution Collection Report.
   • Product Sales Report.
   • Contribution Distribution.
   • User Activity Report.
   • Enrolment Performance Indicators
   • Status of Registers
   • Insures without Photos.
   • Matching Funds.
   • Claim Overview.
   • Payment Category Overview.
   • Families and Insurees Overview.
   • Pending Insurees.
   • Percentage of Referrals.
   • Capitation Payment
   • Rejected Photos
   • Contribution Payment
   • Control Number Assignment
   • Overview of Commissions
   • Claim History

   Report Type Selector
2. Button Panel

   • Preview button

     By clicking on this button, the system will process the selected report type basic on the corresponding criteria submitted and re-direct current user to Report Page, for previewing the processed report. At any time the user clicks on the preview button, the current criteria will be saved in the session and can be reused later in the same session and for other report types where the same criteria are found.

   • Cancel button

     By clicking on this button, the current user will be re-directed to the Home Page <home_page>.

3. Information Panel

   The Information Panel is used to display messages back to the user. Messages will occur if there was an error at any time during the processing of the reports.

Report Preview

The report viewer offers the facility to navigate through the report either by using the arrows or by typing in a page number at the top of the report. Another feature of the report viewer is to export the report in different formats. Currently system supports three formats; Word, Excel and PDF. Select the desired format from the list by clicking on the Export link. Use the Go Back to Selector link to go back to the previous selection page.

Below are the types of reports as they can be seen in the report page.

1. primary operational indicators - policies report

   The report provides aggregate data relating to policies and insurees according to insurance products. The report can be run by users with the system role Manager or with a role including an access to Tools/Reports/Primary Operational Indicators-policies. The table below will provide an overview on primary indicators of the report.

   Table Overview of Policies indicators

   Code	Primary indicators	Dimension	Description
   P1	Number of policies	Time, Insurance product	The number of policies of given insurance product on the last day of a respective period (Status of the policy is Active, the last day of period is within <Effective date, Expiry day>)
   P2	Number of new policies	Time, Insurance product	The number of new policies of given insurance product during a respective period (Enrolment date is within the respective period, there is no preceding policy with the same (or before converted) insurance product forgiven policy)
   P3	Number of suspended policies	Time, Insurance product	The number of policies for given insurance product that were suspended during a respective period (Status of the policy is Suspended, suspension took place within the respective period)
   P4	Number of expired policies	Time, Insurance product	The number of policies for given insurance product that expired during a respective period (Status of the policy is Expired,expiration took place within the respective period)
   P5	Number of renewals	Time, Insurance product	The number of policies that were renewed forgiven insurance product (or a converte done) during a respective period ( Enrolment date is within the respective period, there is a preceding policy with the same (or before converted) product forgiven
   P6	Number of insurees	Time, Insurance product	The number of insurees covered by policies of given insurance product on the last day of a respective period (An insuree belongs to a family with an active coverage on the last day of the respective period-see P1 )
   P7	Number of newly insured insurees	Time, Insurance product	The number of insurees covered by new policies of given insurance product during a respective period (An insuree belongs to a family with newly acquired policy during the respective period-see P2 )
   P8	Newly collected Contributions	Time, Insurance product	Amount of acquired Contributions (for policies of given insurance product) during a respective period ( Date of payment of a Contribution is within the respective period)
   P9	Available Contributions	Time, Insurance product	Amount of Contributions that should be allocated for policies of given insurance product for a respective period provided a uniform distribution throughout the insurance period takes place. (If the respective period overlaps with <Effective date, Expiry day> of a policy then a proportional part of corresponding Contributions relating to the respective period is included in available Contributions)

   Below is an example of the report:

   Preview – Primary Operational Indicators - Policies Report

2. primary operational indicators - claims report

   The report provides aggregate data relating to policies and insurees according to insurance products. The report can be run by users with the system role Manager or with a role including an access to Tools/Reports/Primary Operational Indicators-claims. The table below will provide an overview on primary indicators of the report.

   Table Overview of operational indicators

   Code	Primary indicators	Dimension	Description
   P10	Number of claims	Time, Health facility, Insurance product	The number of claims for given insurance product that emerged during a respective period (Start dateof a claim is within the respective period)
   P11	Amount remunerated	Time, Health facility, Insurance product	Amount remuneratedfor claims for given insurance product that emerged during a respective period (Start dateof a claim is within the respective period)
   P12	Number of rejected claims	Time, Health facility, Insurance product	The number of claims for given insurance product that emerged during a respective period and were rejected (Start dateof a claim is within the respective period and the Status approval ofthe claim is Rejected)

   Below is an example of the report:

   Preview – Primary Operational Indicators - Claims Report

3. derived operational indicators report

   The report provides operational indicators derived from primary operational indicators. The report can be run by users with the system role Manager or with a role including an access to Tools/Reports/Derived Operational Indicators. The table below will provide an overview on the actual derived indicators provided by the report.

   Table Overview of derived operational indicators

   Code	Derived	Dimension	Description
   D1	Incurred claims ratio	Time, Insurance product	It is the ratio P11/P9
   D2	Renewal ratio	Time, Insurance product	It is the ratio P5/P4
   D3	Growth ratio	Time, Insurance product	It is the ratio P2/P1-for immediately preceding period
   D4	Promptness of claims settlement	Time, Insurance product	It is the average (date of sending to payment- Date of submission of the claim) for all claims relating to given insurance product and emerging in a respective period Date of sending of payment is not in the structure of Claim, it has to be retrieved from a journal-can be?)
   D5	Claims settlement ratio	Time, Health facility, Insurance product	It is the ratio (P10-P12)/P10
   D6	Number of claims per insuree	Time, Insurance product	It is the ratio P10/P6
   D7	Average cost per claim	Time, Health facility, Insurance product	It is the ratio P11/P10
   D8	Satisfaction level	TimeDistrict, Health facility	The average mark from feedbacks received in a respective period
   D9	Feedback response ratio	Time, District, Health facility	The ratio of number of feedbacks received (up to time of creation of the report) and number of feedbacks asked for in a respective period

   Below is an example of the report:

   Preview – Derived Operational Indicators Report

4. Contribution collection report

   The report lists all actual payments of contributions according to insurance products in the defined period. The report can be used as input to an accounting system. The report can be run by users with the the system role Accountant or with a role including an access to Tools/Reports/Contribution Collection. Payments are assigned to the specified period according to the actual date of payment. (image228)

   Preview – Contribution Collection Report

5. product sales report

   The report provides overview of selling of policies according to insurance products in terms of calculated contributions (not necessarily actually paid). The report can be run by users with the system role Accountant or with a role including an access to Tools/Reports/Product Sales. Policies are assigned to the specified period according to their effective days. (image229)

   Preview – Product Sales Report

6. Contribution distribution report

   The report provides proportional amount of actually paid contributions allocated by openIMIS to specific months according to insurance products. The report can be run by users with the system role Accountant or with a role including an access to Tools/Reports/Contribution Distribution. This report shows the information about the Total collection, Allocated amount and Not allocated amount for contributions in the specified period.

   Allocated amount is the proportionally calculated amounts of contributions paid covering the month. Not Allocated amount is the amount collected for contributions that have a start date in the future (after the month in question). (image230)

   Preview – Contribution Distribution Report

7. user activity report

   The report shows activities of users according to types of activities and types of entities to which the activities relate. The report can be run by users with system role IMIS Administrator or with a role including an access to Tools/Reports/User Activity. (image231)

   Preview – User Activity Report

8. enrolment performance indicator report

   The report provides overview of activity of enrolment officers. The report can be run by users with the system role Manager or with a role including an access to Tools/Reports/Enrolment Performance Indicator. (image232)

   Preview – Enrolment Performance Indicator Report

9. status of registers report

   The report provides an overview of the number of items in registers according to districts. The report can be run by users with the system role Scheme Administrator or with a role including an access to Tools/Reports/Status of Registers.(image233)

   Preview – Status of Registers Report

10. insurees without photos

    The report lists all insurees according to enrolment officers that have not assigned a photo. The report can be run by users with thesystem role Accountant or with a role including an access to Tools/Reports/Insurees without Photos. (image234)

    Preview – Insurees without photos

11. matching funds

    The report lists all families/groups according to insurance products and (institutional) payers that paid contributions in the specified period. This report is useful for claiming of subsidies for running of health insurance schemes. The report can be run by users with the system role Accountant or with a role including an access to Tools/Reports/Matching Funds. (image235)

    Preview –Matching Funds

12. claim overview

    The report provides detailed data about results of processing of claims in openIMIS according to insurance products and health facilities. The report can be used as a tool for communication between a health insurance scheme and its contractual health facilities. The report can be run by users with the rsystem role Accountant or with a role including an access to Tools/Reports/Claim Overview. Claims are assigned to the specified period according to date of provision of health care (in case of in-patient care according to the date of discharge). (image236)

    Image 236 Preview – Claim Overview

13. payment category overview

    The report provides split of total contributions according to their categories. The report can be run by users with the system role Accountant or with a role including an access to Tools/Reports/Payment Category Overview. Contributions are assigned to the specified period according to actual payment date. (image237)

    Preview – Payment Category Overview

14. Families and Insurees Overview report

    The report provides an overview of enrolled families/groups and their members in specified location within the specified period. The report can be run by users with the system role Accountant or with a role including an access to Tools/Reports/Families and Insurees Overview. (image238)

    Preview – Families and Insurees Overview Report

15. Percentage of Referrals report

    The report lists all primary health care facilities (the category is Dispensary and Health Centre) in the selected district and for each such health facilities provides the following indicators:

    1. The number of visits (claims) of the primary health care facility in the selected period.
    2. The number of out-patient visits that have Visit Type equal to Referral in all other health facilities (irrespective of the district) for insurees with the First Service Point in the respective primary health care facility.
    3. The number of in-patient stays that have Visit Type equal to Referral in all health facilities-hospitals (irrespective of the district) for insurees with the First Service Point in the respective primary health care facility.

    The report can be run by users with the system role Accountant or with a role including an access to Tools/Reports/Percentage of Referrals. (image239)

    Preview – Percentage of Referrals Overview Report

16. Pending Insurees report

    The report lists all insurees whose photos have been sent to openIMIS but who has no record in openIMIS yet. The report can be run by users with the system role Accountant or with a role including an access to Tools/Reports/Pending Insurees. (image240)

    Preview – Pending Insurees Report

17. Renewals report

    The report lists all renewed policies in given period for given insurance product and optionally for given enrolment officer. The families that have at least one payment of contributions in given period of time are included in the report. The report can be run by users with the system role Accountant or with a role including an access to Tools/Reports/Renewals. Below is an example of the report (image241)

    Preview – Renewals Report

18. Capitation Payment Report

    The report lists capitation payments for all health facilities specified in the capitation formula for specified month and for given insurance product. The report can be run by users with the system role Accountant or with a role including an access to Tools/Reports/Capitation Payment. (image242)

    Preview –Capitation Payment Report