How Jiro Attributes Data to Your Practice
- How Claims Attribution Works
- Patient Identification & Deduplication
- What Gets Counted & What Doesn't
- Data Timing & Availability
- Frequently Asked Questions
- Important to Remember
- Related Articles
Jiro builds your patient and encounter counts from claims attributed to your NPI, so you can trust that the numbers reflect your own practice. Knowing which claims count toward you, and which do not, helps you interpret every metric you see.
Claims are attributed to the rendering provider, or to the attending clinician for hospital and emergency department care. Jiro uses the billing provider when either of those is blank and does not attribute claims that have no provider NPI.
How Claims Attribution Works
Jiro builds your patient and encounter counts from claims attributed to your National Provider Identifier (NPI). The rules below show which claims count toward your numbers.
Professional Claims (Office & Clinic Visits)
Jiro attributes office visits and professional services to the rendering provider on the claim. This is the provider who delivered the service. If the rendering provider is blank, Jiro uses the billing provider.
Institutional Claims (Hospital & Emergency Department)
Jiro attributes inpatient and emergency department (ED) care to the attending clinician on the claim, who is the clinician of record. If the attending clinician is blank, Jiro uses the billing provider.
What Is Not Attributed
Jiro excludes claims with no rendering, attending, or billing provider NPI, because it cannot attribute care when no physician is identified. Facility-only claims fall into this category. These are institutional claims billed with only a facility NPI and no attending or billing physician. Jiro does not attribute them to any individual provider.
Some metrics apply additional filters on top of attribution. These filters do not change attribution elsewhere in Jiro.
Patient Identification & Deduplication
Each patient has a unique ID in claims data. If a patient appears more than once in a measurement period, Jiro counts them once.
New vs. Established Patient Status
Patient status comes from the specific CPT or HCPCS procedure codes that providers submit on claims. For this reason, the "new" and "established" counts can differ from your expectations. A patient who has not appeared in claims for an extended period can be counted as "new" when they return.
What Gets Counted & What Doesn't
|
Item |
Inclusion Status |
|---|---|
| Paid claims with your rendering or attending NPI | Yes |
| Denied or reversed claims | Yes, but removed from reimbursements |
| Observation stays | Yes, but removed from specific inpatient metrics |
| Transfers to another facility | No |
| Patients with missing date of birth | No |
| Deceased patients (panel metrics) | No |
| Multiple encounters by same patient per period | Once (deduplicated) |
Jiro includes denied or reversed claims and observation stays in your data. It removes denied or reversed claims from reimbursement figures. It removes observation stays from specific inpatient metrics.
Data Timing & Availability
Medical claims typically settle 30 to 60 days after the service date. Jiro metrics refresh monthly as new paid claims arrive. For a complete and stable view of your practice, review data from at least 6 months before today's date.
Most metrics use rolling 12-month windows that cover the past 12 months of data. Some metrics use fixed quarterly or annual periods, or acute outcome windows (30-day, 72-hour).
Most metrics anchor to an index event, which is the first qualifying encounter in the measurement period. The index event date determines whether a patient is new or established. It also sets the boundaries for look-back and look-forward analyses.
Frequently Asked Questions
If I see a patient multiple times in the same measurement period, do they count multiple times? No. Patients are deduplicated per measurement period. A patient with four separate encounters in a rolling 12-month window counts as one.
Why is a patient classified as established when I thought they were new? Patient status is based on your full claims history. If you saw this patient more than 36 months ago, they reset to new when you encounter them again. If your most recent claim with them is within 36 months, they remain established.
How long does it take for data to appear in Jiro? Claims typically settle 30 to 60 days after service. For complete data, review periods at least 6 months in the past.
Will my metrics change after they are calculated? Yes. Metrics update as new claims arrive, existing claims are reclassified, or data quality corrections occur. This keeps your metrics accurate.
What data sources does Jiro use? Jiro uses de-identified, aggregated medical and pharmacy claims data from a national claims database, linked to your NPI. See Data Sources for full details
Important to Remember
- Claims with no rendering, attending, or billing provider NPI are excluded, including facility-only claims.
- Medical claims typically settle 30 to 60 days after the service date, and metrics refresh monthly.
- For complete and stable data, review periods at least 6 months before today's date.
- A patient last seen more than 36 months ago is counted as new when they return.