Blog/ Claim denials
The new ANS denials dashboard: what is new
Meet the regulator’s new transparency tool, which consolidates metrics on payment times and financial refusal rates to improve the monitoring of cash flow between hospitals and payers
- By
- Rivio, Editorial team
- Published
- Reading time
- 2 minutes
To strengthen transparency and the monitoring of financial performance in private healthcare (supplementary health), Brazil’s National Supplementary Health Agency (ANS) has launched a new open dataset dedicated exclusively to denial indicators.
The initiative is part of the agency’s open data policy and aims to improve the analysis of the financial flow between service providers and health plan operators.
The data are drawn from the Supplementary Health Information Exchange Standard (TISS) and organized into half-yearly dashboards. This allows comparative analyses over time, segmented by type, size and category of payer.
Denial indicators made available by the ANS
The Denial Indicators Dashboard brings together five main metrics, defined through consultations with the sector’s representative bodies, focused on tracking payments and denial practices:
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Average time to payment: calculates the average interval between the submission of forms and actual payment to the provider.
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Initial denial percentage: represents the share of amounts initially denied by payers when claims are processed.
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Final denial percentage: indicates the percentage of denials upheld after appeals, reviews and negotiations between providers and payers.
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Percentage of the number of forms with no response after 60 days: shows the volume of forms that remain without a response from the payer after that period.
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Percentage of the value of forms with no response after 60 days: expresses the financial impact of forms awaiting a response.
These indicators provide an objective view of payers’ operational efficiency and of financial predictability for providers.
How the dashboard works and the analyses it enables
The dashboard is interactive and allows filtering by reference period, type of payer, segmentation and size. This flexibility enables detailed comparative analyses and the identification of behavior patterns related to payment times and upheld denials.
The dashboard’s structure serves different user profiles, including providers, payers, managers, researchers and oversight bodies, reinforcing the strategic use of regulatory data.
Why the data matter for revenue cycle management
Making denial indicators available in open format expands the capacity for critical analysis of financial losses, payment delays and the efficiency of appeal processes. For providers, these data support strategic decisions on contract negotiation, prioritization of appeals and improvement of billing processes.
In addition, access to standardized, auditable information helps reduce information asymmetries in the sector, strengthening the governance and sustainability of the hospital revenue cycle.
The Denial Indicators Dashboard is available on the Brazilian Open Data Portal and can be accessed for queries, data export and custom analyses, according to each institution’s needs.
Access the open data at: https://dados.gov.br/signin
