Operations Dashboard
Real-time monitoring and risk management
Behavior: Dashboard auto-refreshes every 30 seconds. All
amounts displayed in Kenya Shillings (KES).
Claims Overview
1,247
Total Claims
KES 18.4M total value
87
AI-Flagged Claims
KES 4.2M flagged value
23
High-Risk Claims
KES 1.8M at risk
Attention
52
Pending Reviews
KES 2.1M pending
Financial Metrics
KES 18.4M
Total Claims Value
1,247 claims
KES 12.8M
Approved This Month
842 claims | 67.5% approval rate
KES 3.5M
Blocked/Denied
168 claims | 13.5%
KES 2.1M
Under Review
237 claims | 19%
Risk Distribution
High Risk
23
Claims Count
KES 1.8M
Total Value
Requires immediate review
Medium Risk
64
Claims Count
KES 2.4M
>Total Value
Review within 24 hours
Low Risk
1,160
Claims Count
KES 14.2M
>Total Value
Routine processing
Claims by Category
Surgery & Procedures
342
KES 8.9M | Avg: KES 26,023
Hospital Admissions
218
KES 5.2M | Avg: KES 23,853
Outpatient Care
428
KES 2.8M | Avg: KES 6,542
Diagnostic Tests
147
KES 890K | Avg: KES 6,054
Medications
89
KES 420K | Avg: KES 4,719
Emergency Care
23
KES 280K | Avg: KES 12,174
Priority Queue - Flagged Claims
Sorting: Click column headers to sort (default: Risk
Score DESC → Time Since Submission DESC)
| Claim ID ↓ | Provider | Risk Score ↓ | Claim Amount (KES) | Time Since Submission ↑ | Action |
|---|---|---|---|---|---|
| CLM-2024-00789 | St. Mary's Hospital | 92/100 High Risk | KES 452,000 | 4 hours 12 min | |
| CLM-2024-00812 | Metro Clinic Group | 88/100 High Risk | KES 328,000 | 6 hours 45 min | |
| CLM-2024-00756 | Valley Medical Center | 85/100 High Risk | KES 586,000 | 12 hours 20 min | |
| CLM-2024-00823 | Community Health Partners | 67/100 Medium Risk | KES 184,000 | 2 hours 30 min | |
| CLM-2024-00801 | Riverside Urgent Care | 64/100 Medium Risk | KES 127,500 | 8 hours 15 min | |
| CLM-2024-00795 | Summit Surgical Associates | 61/100 Medium Risk | KES 273,000 | 1 day 3 hours | |
| CLM-2024-00834 | Family Care Clinic | 38/100 Low Risk | KES 42,000 | 1 hour 10 min | |
| CLM-2024-00829 | Pediatric Associates | 35/100 Low Risk | KES 68,500 | 5 hours 40 min |
Empty State: When no flagged claims exist, display:
"No flagged claims at this time. All
submissions are processing normally."
Quick Actions
View Provider Profile
View Claim Details
System States (for demonstration)
LOADING STATE:
Loading claims data...
HIGH-RISK ALERT STATE:
Alert 3 critical claims (KES 1.4M) require immediate attention. Review queue updated.
INCOMPLETE DATA STATE:
Warning Claim CLM-2024-00756 (KES 586,000) is missing required documentation. Provider notified.