Dashboard
June 2026
Awaiting Decision
7
↗ Click to review inbox
Approved (MTD)
241
↑ 14% vs last month
Total Paid (MTD, ETB)
4.2M
↑ 8% vs last month
Audit Savings (MTD)
ETB 318K
↑ Synora audit flag
Claims Received from Synora
2026 year-to-date
Decision Breakdown
Current month
Recently Received Claims
Submitted by Synora Health after audit
| Claim ID | Member ID | Member Name | Provider | Service | Audited (ETB) | Status |
|---|---|---|---|---|---|---|
| SH-2026-0291 | AWI-2024-00182 | Almaz Bekele | St. Paul's Hospital | Surgical Procedure | 11,200 | New |
| SH-2026-0290 | AWI-2023-00094 | Tesfaye Girma | Black Lion Hospital | Inpatient | 8,750 | New |
| SH-2026-0289 | AWI-2024-00221 | Hiwot Tadesse | MCM Hospital | Outpatient | 3,200 | Under Review |
| SH-2026-0288 | AWI-2022-00058 | Selamawit Alemu | Bethzatha Hospital | Inpatient | 19,400 | Approved |
| SH-2026-0287 | AWI-2025-00311 | Dawit Mekonnen | Hayat Hospital | Emergency | 6,100 | Paid |
Claims Inbox
Audited claims submitted by Synora Health awaiting your decision.
ℹ️ All claims in this inbox have been reviewed and audited by Synora Health. Audit findings, billing code verification, and clinical review notes are attached to each claim.
7
All Pending
5
New
2
Under Review
0
Queried
Claims History
All claims submitted by Synora Health and their final decisions.
All 284
Approved 198
Paid 67
Rejected 12
Queried 7
Utilization Analytics
Claims utilization data across your membership pool.
Members Covered
1,240
↑ 48 new this month
Utilization Rate
22.9%
↑ 1.4% vs benchmark
Cost Per Member
ETB 3,387
↓ 5% vs last quarter
High-Cost Cases
7
Above ETB 50,000
Claims by Age Group
Top Diagnoses (ICD-10)
Service Type Breakdown
Share of total claims
Outpatient Visit34%
Inpatient Hospitalization22%
Pharmacy18%
Diagnostic / Lab14%
Emergency Care8%
Other4%
Cost Analysis
Expenditure trends and audit savings.
YTD Paid (ETB)
21.4M
↑ 11% vs last year
Audit Savings YTD
ETB 1.8M
Via Synora audit
Loss Ratio
68.3%
Target: 65%
Avg. Approved Claim
ETB 14,789
Post-audit amount
Monthly Claims Expenditure vs. Budget (ETB)
Top 5 Providers by Spend
| Provider | Claims | Paid (ETB) |
|---|---|---|
| Black Lion Hospital | 48 | 3,842,000 |
| St. Paul's Hospital | 41 | 3,210,500 |
| Bethzatha Hospital | 35 | 2,640,000 |
| MCM Hospital | 29 | 1,980,200 |
| Hayat Hospital | 22 | 1,540,800 |
Synora Audit Impact
-
✓ETB 1.8M saved YTD via clinical auditOverbilling, duplicate procedures flagged
-
★Standardized billing reduced disputes by 34%Synora Billing Coding System
-
iOutcomes-based contracting pilot launches Q3 2026Health Financing Analytics
Documents
Reports, policy documents, and billing code references.
Monthly Reports from Synora Health
| Document | Period | Issued | |
|---|---|---|---|
| 📊 Claims Utilization Report | May 2026 | Jun 1, 2026 | |
| 📋 Clinical Audit Summary | May 2026 | Jun 1, 2026 | |
| 💰 Claims Expenditure Statement | May 2026 | Jun 1, 2026 | |
| 📋 Clinical Audit Summary | Q1 2026 | Apr 3, 2026 |
Reference Documents
| Document | Version | |
|---|---|---|
| 📄 Synora Billing Code Reference (SBCS) | 2026 v1 | |
| 📄 Benefits Schedule | 2026 v2 | |
| 📄 Claims Adjudication Guidelines | 2026 v1 | |
| 📄 TPA Service Agreement | 2026 |