Daily Claims Productivity Per User
The Claims Productivity Per User operational report allows users to monitor and assess daily claims productivity per user.
Objective
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Monitor workload: Track the number of claims each user processes daily to ensure balanced task distribution.
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Assess productivity: Evaluate individual performance and efficiency, including same-day processing.
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Identify training needs: Identify users who may require additional support or guidance such as those with high rework (multiple submissions on a single claim).
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Support planning: Provide insights for staffing, scheduling, and resource allocation decisions.
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Reporting View Fields
The following lists the reporting fields for the Daily Claims Productivity Per User.
| Field Name | Description |
|---|---|
Last Updated Date |
The date based on the claim’s last updated date (submit or finalize) for the daily productivity summary. |
User ID |
Unique identifier of the user who performed the activity. |
User Name |
Displays the user’s name (including internal system users). |
Total Submitted Claim Count |
Total claims count submitted by the user on the specific date (counts every submission, including reworks). |
Total Distinct Submitted Claim Count |
Total finalized claims count by user on the specific date. |
Total Distinct Finalized Claim Count |
Total distinct claims count finalized for the user on the specific date (derived from total finalized count, signals rework if high total vs. low distinct). |
Total Claim Line Count |
Total Claim lines count from the total distinct finalized claim count column. |
Use Cases for Summarized Counts
The following use cases show how the report aggregates data from claim history.
Use Case 1: Multiple Submissions and Finalizations
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The same user submits and finalizes the same claim multiple times on the same day.
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Different users submit and finalize the same or different claims on the same day.
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Different users submit and finalize different claims on the same day.
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Pros: Provides transparency in crediting finalizations, pend or recycled claims get distinct submitted counts to avoid inflation.
Use Case 2: Technical Error - Same User Fixes
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Claim CLA101 hits a technical error after submission.
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The original user John fixes and restarts the claim the next day, leading to finalization.
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Pros: Credit for technical error claims counts for the original submitter (or fixer if the same user), even without a new submit entry on the fix day.
Use Case 3: Technical Error - Different User Fixes
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Claim CLA101 hits a technical error after John’s submission.
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Another user (Sam, who did not submit it) fixes and restarts the claim the next day, leading to finalization.
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Pros: Original users receive credit.
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Cons: The fixer (Sam) receives no credit for his fix and submission.
Use Case 4: Reprocessing Claim
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A claim undergoes reprocessing (for example, for corrections), which does not create a submit history entry.
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Credits appear under the system user for finalizations.
Sample Claim Data Table
The following table shows raw data from claim history tables to explain the use cases. This data is not displayed in the report, it shows how submissions and finalizations aggregate.
| USER | CLAIM SUBMITTED DATE | CLAIM SUBMITTED ID | CLAIM FINALIZED DATE | CLAIM FINALIZED ID | USE CASE |
|---|---|---|---|---|---|
John |
03-11-2025 |
CLA001, CLA001 |
03-11-2025 |
CLA001, CLA001 |
Use Case 1 |
Sam |
03-11-2025 |
CLA001, CLA001, CLA100 |
03-11-2025 |
CLA001, CLA001, CLA100 |
Use Case 1 |
John |
04-11-2025 |
CLA101 |
- |
- |
Use Case 2 |
John |
05-11-2025 |
- |
05-11-2025 |
CLA101 |
Use Case 2 |
Sam |
05-11-2025 |
- |
05-11-2025 |
CLA101 |
Use Case 3 |
Internal system User |
05-11-2025 |
- |
05-11-2025 |
CLA110, CLA111,…CLA160 |
Use Case 4 |
John |
06-11-2025 |
CLA165 |
- |
- |
Use Case 5 |
Sam |
07-11-2025 |
CLA165 |
07-11-2025 |
CLA165 |
Use Case 5 |
Alex |
07-11-2025 |
CLA167 |
07-11-2025 |
CLA167 |
Use Case 6 |
Result of Use Cases
The following table shows how the sample data aggregates into report counts.
| Claim codes are not displayed in the report. The example above is provided to illustrate how the data are summarized. |
| DATE | USER NAME | TOTAL SUBMITTED CLAIM COUNT | TOTAL DISTINCT SUBMITTED CLAIM COUNT | TOTAL FINALIZED CLAIM COUNT | TOTAL DISTINCT FINALIZED CLAIM COUNT | TOTAL CLAIM LINE COUNT | Comment |
|---|---|---|---|---|---|---|---|
03-11-2025 |
John |
2 = (CLA001, CLA001) |
1 = (CLA001) |
2 = (CLA001, CLA001) |
1 = (CLA001) |
1 |
Use Case 1 |
03-11-2025 |
Sam |
3 = (CLA001, CLA001, CLA100) |
2 = (CLA001, CLA100) |
3 = (CLA001, CLA001, CLA100) |
2 = (CLA001, CLA100) |
1 |
Use Case 1 |
04-11-2025 |
John |
1 = (CLA101) |
1 = (CLA101) |
0 |
0 |
0 |
Use Case 2 |
05-11-2025 |
John |
0 |
0 |
1 = (CLA101) |
1 = (CLA101) |
1 |
Use Case 2 |
05-11-2025 |
Sam |
0 |
0 |
0 |
0 |
0 |
Use Case 3 |
05-11-2025 |
System |
0 |
0 |
50 = (CLA110, CLA111,…CLA160) |
50 = (CLA110, CLA111,…CLA160) |
50 |
Use Case 4 |
06-11-2025 |
John |
1 = (CLA165) |
1 = (CLA165) |
0 |
0 |
0 |
Use Case 5 |
07-11-2025 |
Sam |
1 = (CLA165) |
1 = (CLA165) |
1 = (CLA165) |
1 = (CLA165) |
1 |
Use Case 5 |
07-11-2025 |
Alex |
1 = (CLA167) |
1 = (CLA167) |
1 = (CLA167) |
1 = (CLA167) |
1 |
Use Case 6 |
Sample Output for the Report
The report displays aggregated counts only (no claim IDs). The following table shows a sample result in descending date order.
| DATE | USER NAME | TOTAL SUBMITTED CLAIM COUNT | TOTAL DISTINCT SUBMITTED CLAIM COUNT | TOTAL FINALIZED CLAIM COUNT | TOTAL DISTINCT FINALIZED CLAIM COUNT | TOTAL CLAIM LINE COUNT |
|---|---|---|---|---|---|---|
07-11-2025 |
Alex |
1 |
1 |
1 |
1 |
1 |
07-11-2025 |
Sam |
1 |
1 |
1 |
1 |
1 |
06-11-2025 |
John |
1 |
1 |
0 |
0 |
0 |
05-11-2025 |
System |
0 |
0 |
50 |
50 |
50 |
05-11-2025 |
John |
1 |
1 |
0 |
0 |
0 |
04-11-2025 |
John |
1 |
1 |
0 |
0 |
0 |
03-11-2025 |
Sam |
3 |
2 |
3 |
2 |
2 |
03-11-2025 |
John |
2 |
1 |
2 |
1 |
1 |