Optivise — Revenue Intelligence Platform

✦ AI Work Plan

Work Queue

Risk-prioritized items requiring attention

Revenue Trend

Monthly billed vs collected

Current upload

Claim Status

Distribution & pending dollars

Collection Rate

By payer

Payer Performance

Billed vs collected

Automation Feed

System activity

CPT Performance

Collection rate by code

Denial Trend

Monthly denied + rejected

Claims Register

Full claim-level detail with risk and activity log

Claim ID	Payer	DOS	CPT	Billed	Paid	Balance	Risk	Status	Activity

Denial Analysis

Denied + rejected claims with appeal recommendations

Denials by Payer

Denials by CPT

Monthly Denial Trend

Denied / Rejected Detail

Claim ID	Payer	DOS	CPT	Billed	Risk	Status	Recommended Action	Activity

Payer Performance

Collection rates and reimbursement analysis

Billed vs Collected

Collection Rate %

Payer Summary

Payer	Claims	Billed	Collected	Write-Off	Deductible	Copay	Collect Rate	Denial Count	Performance

AR Aging

Outstanding receivables by age

Aging Buckets

Outstanding by Payer

Aging Detail

CPT Analytics

Procedure-level performance

Billed vs Collected by CPT

Average Reimbursement

CPT Summary Table

CPT Code	Description	Volume	Total Billed	Total Collected	Avg Billed	Avg Paid	Collect Rate	Denial Rate

Underpayment Analysis

Compare paid amounts against client payer fee schedules

Top Underpaying Payers

Detected contract variance

Top Underpaid CPT Codes

Estimated recoverable revenue

Fee Schedule / Contract Rates

Stored by workspace/client

Client	Payer	Plan	CPT	Modifier	Allowed	Effective	Expiration	Type	Action

Underpayment Work Queue

Every underpaid claim creates a queue item

Claim ID	Payer	CPT	Expected	Paid	Variance	Status	Risk	AI Suggestion	Activity

Work Queues

AI risk scoring prioritizes every claim from 0–100

Priority	Claim ID	Client	Payer	CPT	Balance	Age	Days to File	Risk Score	AI Recommendation	Assigned User	Status	Due Date	Activity

Staff Productivity

User-level scorecards, productivity benchmarks, and revenue impact

Productivity Benchmarks

Internal AHR operating targets

Daily Activity Trend

Claims touched, denials, underpayments

Staff Scorecards

Click a staff name or a metric card to see the exact claims they worked

User	Claims Touched	Denials Worked	Underpayments Reviewed	Appeals Prepared	Resolved	Claims / Hr	Queue Completion	AI Adherence	Revenue Impact	Status

Clearinghouse Monitoring

Future-state integration layer for real-time claim status, rejection monitoring, payer response tracking, and payment activity.

⇄

Integration Layer

Future

No live API connection enabled

⏳

Pending Setup

0

Configured placeholders

✓

Connected

0

Future API connections

!

Not Connected

0

Awaiting implementation

Clearinghouse Connections

Connection status placeholders only

Clearinghouse	Status	Future Capability	Last Sync	Notes

Data Manager

Central dataset management for claims, payments, denials, fee schedules, productivity logs, and work queue exports

Imported Datasets

Active workspace uploads and managed data assets

Dataset Type	Workspace	Records	Upload Date	Saved By	Actions

Select all on page

	Claim ID	Payer	DOS	CPT	Billed	Paid	Status	Risk	Action

Report Generator

Generate client-ready reports from loaded data or a new upload

Data Summary

No data loaded yet.
Upload a file or switch to Dashboard Data mode.

Column Mapping