Healthcare Revenue Cycle Management (RCM) & Billing Dataset – 1,000 Records

Master healthcare data analytics with this professionally structured synthetic dataset. Designed to mimic the complexity of a hospital’s financial operations, this dataset is perfect for building portfolios, practicing SQL/Power BI/Tableau, or preparing for healthcare analyst interviews.

What’s Included?

A comprehensive Excel workbook featuring:

• 1,000 Rows of Raw Claims Data: Cleaned and structured for immediate analysis.
• Key Performance Indicators (KPI) Sheet: Pre-calculated metrics including Collection Rates and Denial Counts.
• Realistic Business Logic: Includes insurance adjustments, denial reasons, and varying settlement timelines.

Core Data Attributes

• Patient & Encounter Tracking: Unique IDs for patients and medical encounters.
• Provider & Departmental Insights: Data across 8 departments (e.g., Cardiology, Emergency, Pediatrics).
• Financial Details: Gross charges vs. actual amounts paid.
• Claim Adjudication: Tracks "Paid," "Denied," and "Pending" statuses with 6+ specific denial reasons (e.g., Medical Necessity, Prior Authorization).
• Insurance Payer Mix: Includes major payers (e.g., UAP Old Mutual, Prudential, Jubilee) and Self-Pay scenarios.

Key Learning Objectives / Use Cases

This dataset allows users to perform critical healthcare analytics tasks:

1. Denial Rate Analysis: Identify which payers or departments have the highest rejection rates.
2. Aging Reports (A/R): Calculate the average "Days to Settlement" to find bottlenecks in the revenue cycle.
3. Revenue Leakage: Compare total charges against insurance payments to analyze contractual write-offs.
4. Provider Benchmarking: Evaluate revenue generated per physician.