Medocare Health Systems
Network Administrator
MC

Network Overview

Real-time clinic network health & performance metrics

Total Clinics
8
Active in network
↑ 2 new this month
Active Claims
174
Pending adjudication
₱2.3M total value
Avg Payment Days
7.2
vs 5-day SLA target
↑ 2.2 days over SLA
Network Health
87%
Trust meter average
4 excellent clinics
Approval Rate
92%
First-pass approval
↑ 3% vs last month
Denial Rate
8%
Claims denied/rejected
↓ 2% improvement

Clinic Network Status

Clinic Name Tenure Trust Meter Claims (30d) Approval Rate Avg Payment Days Status
Oxford Diagnostic Lab 3 months
95
47 95% 6.5 days Excellent
MyHealth Clinic (SM North) 2 months
72
23 82% 9.2 days Caution
Healthcare Plus Makati 4 months
88
34 91% 7.1 days Good
Prime Diagnostics BGC 5 months
92
52 94% 6.8 days Excellent

⚠️ Network Alerts & Recommendations

⚠️
MyHealth Clinic: Quality Concerns
15% denial rate (3x network avg). Recommend documentation coaching on prior auth requirements.
3 hours ago
Oxford Diagnostic: SLA Compliance
2 appeals submitted this week. Review and approve within SLA (15 days).
Yesterday at 2:15 PM
Prime Diagnostics: Network Expansion Opportunity
Trust meter 92/100. Consider expanding relationship or preferred partnership tier.
2 days ago

Clinic Management

Manage, monitor, and communicate with your clinic network

Oxford Diagnostic Lab
Contact
Excellent
📍 Makati, Metro Manila
☎️ +63 2 8XXX XXXX
📧 oxford@diagnostic.com
👤 Dr. Maria Santos (Director)
MyHealth Clinic (SM North)
Contact
Caution
📍 Quezon City, NCR
☎️ +63 2 8XXX XXXX
📧 myhealth@equicom.com
👤 Ms. Jinky Usi (Manager)
Prime Diagnostics BGC
Contact
Excellent
📍 Bonifacio Global City
☎️ +63 2 8XXX XXXX
📧 prime@diagnostics.com
👤 Mr. Juan dela Cruz (Manager)
Healthcare Plus Makati
Contact
Good
📍 Makati, Metro Manila
☎️ +63 2 8XXX XXXX
📧 healthcare@plus.com
👤 Ms. Jennifer Reyes (Admin)

Clinic Performance Comparison

Clinic Monthly Claims Revenue (₱) Quality Score Payment Days Relationship Strength
Oxford Diagnostic Lab 47 ₱564,000 95/100 6.5
Prime Diagnostics BGC 52 ₱624,000 92/100 6.8
Healthcare Plus Makati 34 ₱408,000 88/100 7.1
MyHealth Clinic (SM North) 23 ₱276,000 72/100 9.2

Claims Management

Real-time claim tracking and status updates across all clinics

Total Claims (30d)
220
All statuses combined
₱2.64M total value
Pending Review
28
Awaiting adjudication
₱336K pending
Approved & Paid
180
Successfully processed
₱2.16M paid out
Denied/Rejected
12
Requires resubmission
₱144K denied

Recent Claims

Claim ID Clinic Patient Service Date Amount (₱) Submitted Status Days Pending
CLM-4521 Oxford Diagnostic John Doe 2024-05-15 15,000 2024-05-16 Paid 5
CLM-4522 Prime Diagnostics Jane Smith 2024-05-17 12,500 2024-05-17 Paid 3
CLM-4523 MyHealth Clinic Robert Johnson 2024-05-18 18,000 2024-05-19 Pending 2
CLM-4524 Healthcare Plus Maria Garcia 2024-05-16 8,500 2024-05-17 Denied 4
CLM-4525 Oxford Diagnostic Carlos Lopez 2024-05-19 22,000 2024-05-20 Pending 1
CLM-4526 Prime Diagnostics Anna Wilson 2024-05-14 9,500 2024-05-15 Paid 6

Network Analytics

Deep insights into clinic performance, denials, and trends

Claims Processing Trend

Approved
180
Pending
28
Denied
12

Top Denial Reasons

Prior auth required
35%
Patient not eligible
25%
Missing documentation
20%
Coding error
15%
Other
5%

Clinic Performance Metrics

Oxford Diagnostic
95%
Prime Diagnostics
92%
Healthcare Plus
88%
MyHealth Clinic
72%

Payment Timeliness vs SLA

On time (≤5 days)
45%
Delayed (6-10 days)
35%
Very late (10+ days)
20%
SLA Target: 95% of claims paid within 5 days
Current Performance: 45% on-time (Need improvement)

Payment Processing

Manage, schedule, and track clinic payments

💰
Total Payable
₱2.64M
Paid This Month
₱2.16M
Pending Payment
₱480K
⚠️
Overdue (10+ days)
₱96K

Payment Schedule & History

Payment ID Clinic Amount (₱) Claims Included Scheduled Date Paid Date Status SLA Compliance
PAY-1001 Oxford Diagnostic ₱281,000 15 claims 2024-05-20 2024-05-20 Completed ✓ On Time
PAY-1002 Prime Diagnostics ₱312,000 18 claims 2024-05-20 2024-05-21 Completed ✓ On Time
PAY-1003 Healthcare Plus ₱204,000 12 claims 2024-05-20 2024-05-24 Completed ⚠️ Late (4 days)
PAY-1004 MyHealth Clinic ₱138,000 8 claims 2024-05-22 - Scheduled Upcoming
PAY-1005 Oxford Diagnostic ₱96,000 6 claims 2024-05-25 - Pending Awaiting Approval

Payment Performance by Clinic

Avg Payment to Oxford
6.5d
Avg Payment to Prime
6.8d
Avg Payment to Healthcare Plus
9.2d
Avg Payment to MyHealth
10.5d

Monthly Payment Trends

Total Payouts
₱2.16M
SLA Compliance
45%
Late Payments
55%

Clinic Messaging

Direct communication channel with clinic network

Recent Conversations

Clinic Contact Person Last Message Message Preview Date/Time Status
Oxford Diagnostic Lab Dr. Maria Santos You Regarding the 2 appeals submitted - please review and approve within 15 days SLA... Today, 2:30 PM Delivered
Prime Diagnostics BGC Mr. Juan dela Cruz Clinic Hi, just to confirm the May 25 payment schedule. Looking good! 👍 Today, 10:15 AM Read
MyHealth Clinic (SM North) Ms. Jinky Usi Clinic We'd like to schedule a call to discuss the denial rate improvement plan... Yesterday, 4:45 PM Unread
Healthcare Plus Makati Ms. Jennifer Reyes You Thanks for the monthly performance report. Will review and get back to you... 3 days ago Delivered

Conversation with Oxford Diagnostic Lab

OD
Dr. Maria Santos
Hi! Following up on May's claim submissions. When can we expect the payment for the pending appeals?
Today, 1:15 PM
MC
You (Medocare)
Good afternoon! The 2 appeals are under review now. We're targeting approval by May 28th (within 15-day SLA). Will send confirmation once approved.
Today, 2:30 PM