Where your revenue comes from determines both your margin and your risk. A DME supplier heavily concentrated in one payer — often Medicare — is exposed to a single rate change or policy shift, while a healthier commercial mix usually pays more per claim. And beyond the mix, two contract questions decide cash quality: how fast does each payer pay, and where are they paying below what the contract allows? This dashboard shows the mix-and-speed side of revenue, where contracting and growth decisions get made.
What this report answers
Who pays us, how much of the business depends on each, how fast do they pay, and where are we being underpaid? The payer-mix page shows total revenue, Medicare and commercial mix rates, and paid claims, with revenue by payer (and by payer type split across product category) so concentration is obvious. The contract-and-speed page adds average days to pay and underpayment dollars, with days-to-pay and underpayment by payer and a payer table tying revenue, mix share, payment speed, and underpayment together.
The metrics that matter
Payer mix — Medicare mix rate and commercial mix rate — is the concentration picture: a high single-payer share is your biggest contract risk. Average days to pay (days-to-pay ÷ paid claims) is the cash-velocity measure, and it varies sharply by payer; a slow payer ties up working capital regardless of how much it ultimately pays. Underpayment dollars is the quiet one — allowed-minus-paid where a payer reimbursed below the contracted rate, money you're entitled to and may not be chasing.
Why the data is trapped
Paid amounts, payment dates, and contracted allowables sit across the remittance feed and the contract terms inside Brightree, NikoHealth, Bonafide, or WellSky DME. Platforms report revenue by payer easily enough, but computing days-to-pay per payer and — harder — flagging underpayments against contracted rates requires joining remittance data to contract terms. That's why underpayment recovery is one of the most commonly missed dollars in DME: nobody's comparing paid to contracted at scale.
How to read it
Start with concentration: if one payer drives most of your revenue, that's your single biggest exposure, and the report quantifies it. Then read days-to-pay by payer — a slow payer is a working-capital drag worth a process or escalation fix. Underpayment by payer is found money: a payer with material underpayment dollars is reimbursing below contract and should be audited and appealed. The product-category split by payer type shows which lines lean Medicare versus commercial.
This report pairs with the net-reimbursement-per-item dashboard: that one answers "what does each setup and item net after write-offs and patient pay," while this one answers "who pays us, how fast, and where are they underpaying against contract" — the mix, speed, and contract-compliance side, where negotiation and growth decisions live. This sample uses fully synthetic claims — no PHI.
Metrics it tracks
| Metric | What it means |
|---|---|
| Total Revenue | Total payments received across all claims — SUM(PaidAmount). |
| Medicare Mix Rate | Share of revenue from Medicare — SUM(PaidAmount) where Payer = Medicare ÷ SUM(PaidAmount). |
| Commercial Mix Rate | Share of revenue from commercial payers — SUM(PaidAmount) where PayerType = Commercial ÷ SUM(PaidAmount). |
| Avg Days to Pay | Average submission-to-payment days — SUM(DaysToPay) ÷ SUM(PaidClaimFlag). |
| Underpayment Dollars | Allowed-minus-paid below contract across claims — SUM(UnderpaymentAmount). |
| Paid Claims | Count of paid claims — rows where PaidClaimFlag = 1. |
Used by: DME/HME owner; billing & contracting lead
Frequently asked questions
Why does payer mix matter for a DME supplier?
Payer mix is the share of revenue from each payer (Medicare, Medicaid, commercial). It sets your blended margin, since commercial plans generally pay more per claim than Medicare, and it sets your risk — a high single-payer concentration means one rate change or policy shift can swing the whole business. Tracking the mix is how you see and manage both.
What are underpayment dollars in DME?
Underpayments are claims a payer reimbursed below the contractually allowed rate — allowed minus paid where paid fell short of contract. They're commonly missed because catching them requires comparing every remittance against contract terms at scale. Surfacing underpayment dollars by payer turns them into a concrete recovery and appeal list.
Why track average days to pay by payer?
Days to pay is submission-to-payment time, and it varies widely by payer. A slow payer ties up working capital even if it eventually pays in full, so tracking days-to-pay per payer highlights where to escalate, tighten submission, or factor payment timing into cash-flow planning.
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