{"#title":"Dental Claims Quality Assurance: Dental Claims Payment Accuracy","#attached":{"library":["mqis\/reports"],"drupalSettings":{"mqis":{"measures":{"118205":{"xcomps":[],"ycomps":[],"complegend":[],"compdata":{"Contract Requirement":[{"name":"Contract Requirement","data_source":"Contract","data_source_order":"1","notes":"","year":"2024","year_type":"CY","measure_name":"Dental Claims Quality Assurance: Dental Claims Payment Accuracy"},{"name":"Contract Requirement","data_source":"Contract","data_source_order":"1","notes":"","year":"2024","year_type":"CY","measure_name":"Dental Claims Quality Assurance: Dental Claims Payment Accuracy"}]},"ymax":115,"comp_table":"<table class=\"table table-striped td-borders responsive-enabled\" data-striping=\"1\">\n      <caption>Dental Claims Quality Assurance: Dental Claims Payment Accuracy - Comparators <span class=\"normal\">(<a href=\"\/mqis\/reports\/csv\/comp118205\/1748375159\">Export<\/a>)<\/span><\/caption>\n  \n  \n      <thead>\n      <tr>\n                  <th class=\"hidden-column is-active\" aria-sort=\"ascending\"><a href=\"\/mqis\/reports\/measure\/118205\/ajax?sort=desc&amp;order=Original%20Order\" title=\"sort by Original Order\" rel=\"nofollow\">Original Order<span class=\"tablesort tablesort--desc\">\n  <span class=\"visually-hidden\">\n    Sort descending\n      <\/span>\n<\/span>\n<\/a><\/th>\n                  <th class=\"hidden-column\"><a href=\"\/mqis\/reports\/measure\/118205\/ajax?sort=asc&amp;order=Measure%20ID\" title=\"sort by Measure ID\" rel=\"nofollow\">Measure ID<\/a><\/th>\n                  <th><a href=\"\/mqis\/reports\/measure\/118205\/ajax?sort=asc&amp;order=Measure%20Name\" title=\"sort by Measure Name\" rel=\"nofollow\">Measure Name<\/a><\/th>\n                  <th><a href=\"\/mqis\/reports\/measure\/118205\/ajax?sort=asc&amp;order=Comparator%20Name\" title=\"sort by Comparator Name\" rel=\"nofollow\">Comparator Name<\/a><\/th>\n                  <th><a href=\"\/mqis\/reports\/measure\/118205\/ajax?sort=asc&amp;order=Comparator%20Type\" title=\"sort by Comparator Type\" rel=\"nofollow\">Comparator Type<\/a><\/th>\n                  <th class=\"hidden-column\"><a href=\"\/mqis\/reports\/measure\/118205\/ajax?sort=asc&amp;order=Year\" title=\"sort by Year\" rel=\"nofollow\">Year<\/a><\/th>\n                  <th><a href=\"\/mqis\/reports\/measure\/118205\/ajax?sort=asc&amp;order=Value\" title=\"sort by Value\" rel=\"nofollow\">Value<\/a><\/th>\n              <\/tr>\n    <\/thead>\n  \n      <tbody>\n              <tr>\n                      <td field=\"original_order\" class=\"hidden-column\">0<\/td>\n                      <td field=\"measure_identifier\" class=\"hidden-column\">DENTAL_CLAIM.04<\/td>\n                      <td field=\"measure_name\" class=\"alignleft\">Dental Claims Quality Assurance: Dental Claims Payment Accuracy<\/td>\n                      <td field=\"name\" class=\"alignleft\">Contract Requirement CY 2024<\/td>\n                      <td field=\"type\">Contract Requirement<\/td>\n                      <td field=\"comparator_year\" class=\"hidden-column\">2024<\/td>\n                      <td field=\"rate_comparator_value\">97.0<\/td>\n                  <\/tr>\n          <\/tbody>\n    <\/table>\n","xseries":{"2023-06":"Qtr2 2023","2023-09":"Qtr3 2023","2023-12":"Qtr4 2023","2024-03":"Qtr1 2024","2024-06":"Qtr2 2024","2024-09":"Qtr3 2024","2024-12":"Qtr4 2024","2025-03":"Qtr1 2025"},"yseries":{"Dental Claims Quality Assurance: Dental Claims Payment Accuracy":{"2023-06":"92.6","2023-09":"99.8","2023-12":"100.0","2024-03":"100.0","2024-06":"100.0","2024-09":"100.0","2024-12":"100.0","2025-03":"100.0"}},"trendlegend":{"Dental Claims Quality Assurance: Dental Claims Payment Accuracy":"Total (All Subgroups)"},"numerators":{"Dental Claims Quality Assurance: Dental Claims Payment Accuracy":[6414,10215,9188,13219,12859,11898,13069,14391]},"denominators":{"Dental Claims Quality Assurance: Dental Claims Payment Accuracy":[6924,10238,9189,13221,12864,11899,13069,14391]},"timeperiods":{"t_2023-04-01_2023-06-30":{"start":"1680321600","end":"1688097600"},"t_2023-07-01_2023-09-30":{"start":"1688184000","end":"1696046400"},"t_2023-10-01_2023-12-31":{"start":"1696132800","end":"1703998800"},"t_2024-01-01_2024-03-31":{"start":"1704085200","end":"1711857600"},"t_2024-04-01_2024-06-30":{"start":"1711944000","end":"1719720000"},"t_2024-07-01_2024-09-30":{"start":"1719806400","end":"1727668800"},"t_2024-10-01_2024-12-31":{"start":"1727755200","end":"1735621200"},"t_2025-01-01_2025-03-31":{"start":"1735707600","end":"1743393600"}},"data_elements":[{"data_element_id":"255903","identifier":"DENTAL_CLAIM.04-D_NUM","measure_id":"118209","type":"1","tech_definition":"<p>Total count&nbsp;of sampled <strong>Prosthodontics (Removable) Dental Claims (D5000-D5899)<\/strong> from the denominator that are paid or denied correctly during the measurement period.<\/p>\r\n\r\n<ul>\r\n\t<li>Claims with errors on two or more lines count as one claim.<\/li>\r\n<\/ul>","class":"1","uploader_user_id":"37","last_modified":"1711033945","spec_id":"784","data_element_class_name":"Numerator"},{"data_element_id":"255904","identifier":"DENTAL_CLAIM.04-D_DEN","measure_id":"118209","type":"1","tech_definition":"<p>The total count of sampled <strong>Prosthodontics (Removable) Dental Claims <\/strong>reviewed during the measurement period.<\/p>\r\n\r\n<ul>\r\n\t<li>Use CDT codes <strong>D5000-D5899<\/strong>.<\/li>\r\n\t<li>When generating the sample, each claim will count as one claim, regardless of the number of lines on the claim.<\/li>\r\n\t<li>Include adjusted claims where the adjustment occurred during the measurement period.<\/li>\r\n\t<li>Include claims partially paid during the measurement period, where at least one line is paid and one or more lines are denied.<\/li>\r\n\t<li>Exclude claims voided during the measurement period.<\/li>\r\n\t<li>If there were no claims received or reviewed for this submeasure category, submit zero as your denominator, numerator, rate and weight.<\/li>\r\n<\/ul>","class":"2","uploader_user_id":"37","last_modified":"1711563864","spec_id":"784","data_element_class_name":"Denominator"},{"data_element_id":"255905","identifier":"DENTAL_CLAIM.04-D_RATE","measure_id":"118209","type":"1","tech_definition":"<p><a href=\"http:\/\/mqis.sr.unh.edu\/mqis\/measure-details\/2843\/rate-wizard\">Numerator\/Denominator*100<\/a><br \/>\r\nData should be truncated to two decimal places. MQIS will round it up to one decimal place.<\/p>","class":"3","uploader_user_id":"37","last_modified":"1718913687","spec_id":"784","data_element_class_name":"Rate"},{"data_element_id":"255942","identifier":"DENTAL_CLAIM.04-D_WEIGHT","measure_id":"118209","type":"1","tech_definition":"<p>The total number of <strong>Prosthodontics (Removable) Dental Claims<\/strong> coming into the system for review from which the sample is drawn.<\/p>","class":"7","uploader_user_id":"37","last_modified":"1711034825","spec_id":"784","data_element_class_name":"Weight"}],"data_table":"<table class=\"table table-striped td-borders responsive-enabled\" data-striping=\"1\">\n      <caption>Dental Claims Quality Assurance: Dental Claims Payment Accuracy <span class=\"normal\">(<a href=\"\/mqis\/reports\/csv\/data118205\/1748375159\">Export<\/a>)<\/span><\/caption>\n  \n  \n      <thead>\n      <tr>\n                  <th class=\"date-range-column\">Time Period<\/th>\n                  <th>Measure Name<\/th>\n                  <th>Measure Numerator<\/th>\n                  <th>Measure Denominator<\/th>\n                  <th>Measure Rate<\/th>\n                  <th>Confidence Interval<\/th>\n              <\/tr>\n    <\/thead>\n  \n      <tbody>\n              <tr>\n                      <td>2023-04-01 - 2023-06-30<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">6,414<\/td>\n                      <td class=\"alignright\">6,924<\/td>\n                      <td class=\"alignright\">92.6%<\/td>\n                      <td>91.9 - 93.3<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2023-07-01 - 2023-09-30<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">10,215<\/td>\n                      <td class=\"alignright\">10,238<\/td>\n                      <td class=\"alignright\">99.8%<\/td>\n                      <td>99.7 - 99.9<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2023-10-01 - 2023-12-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">9,188<\/td>\n                      <td class=\"alignright\">9,189<\/td>\n                      <td class=\"alignright\">100.0%<\/td>\n                      <td>100.0 - 100.0<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2024-01-01 - 2024-03-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">13,219<\/td>\n                      <td class=\"alignright\">13,221<\/td>\n                      <td class=\"alignright\">100.0%<\/td>\n                      <td>100.0 - 100.0<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2024-04-01 - 2024-06-30<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">12,859<\/td>\n                      <td class=\"alignright\">12,864<\/td>\n                      <td class=\"alignright\">100.0%<\/td>\n                      <td>100.0 - 100.0<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2024-07-01 - 2024-09-30<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">11,898<\/td>\n                      <td class=\"alignright\">11,899<\/td>\n                      <td class=\"alignright\">100.0%<\/td>\n                      <td>100.0 - 100.0<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2024-10-01 - 2024-12-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">13,069<\/td>\n                      <td class=\"alignright\">13,069<\/td>\n                      <td class=\"alignright\">100.0%<\/td>\n                      <td>N\/A<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2025-01-01 - 2025-03-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">14,391<\/td>\n                      <td class=\"alignright\">14,391<\/td>\n                      <td class=\"alignright\">100.0%<\/td>\n                      <td>N\/A<\/td>\n                  <\/tr>\n          <\/tbody>\n    <\/table>\n","suppressed":false,"orgs":{"DMCM: Northeast Delta Dental":16},"qualifiers":{"Qtr1 2024":[],"Qtr1 2025":[],"Qtr2 2023":[],"Qtr2 2024":[],"Qtr3 2023":[],"Qtr3 2024":[],"Qtr4 2023":[],"Qtr4 2024":[]},"verifieds":{"2023-06":{"16":false},"2023-09":{"16":false},"2023-12":{"16":false},"2024-03":{"16":false},"2024-06":{"16":false},"2024-09":{"16":false},"2024-12":{"16":false},"2025-03":{"16":false}},"measure":{"measure_id":"118205","identifier":"DENTAL_CLAIM.04","name":"Dental Claims Quality Assurance: Dental Claims Payment Accuracy","description":"<p>Percent of all <strong>Dental Claims<\/strong> paid or denied correctly during the measurement period by dental category of service: A. Diagnostic; B. Preventive; C. Restorative; D. Prosthodontics (Removable); E. Oral and Maxillofacial Surgery; F. Adjunctive; G. Periodontics; H. Maxillofacial Prosthetics; I. Implant Services<\/p>\r\n\r\n<p>&nbsp;<\/p>\r\n\r\n<p><strong>Note:<\/strong> Percent is derived from the sampled dental claims.<\/p>","tech_definition":"<p>This measure is a parent measure that groups together related submeasures. Data is submitted only for submeasures. After submission of submeasure data, the system calculates the parent measure by totaling together the submitted submeasures. Each submeasure has its own measure and data element technical specifications detail. The information below provides a general technical description of the measure as a whole.<\/p>\r\n\r\n<p><strong>Submeasures:<\/strong> The measure is reported for nine submeasures: A. Diagnostic; B. Preventive; C. Restorative; D. Prosthodontics, Removable; E. Oral and Maxillofacial Surgery; F. Adjunctive; G. Periodontics; H. Maxillofacial Prosthetics; I. Implant Services<\/p>\r\n\r\n<h3><strong>Sampling:<\/strong><\/h3>\r\n\r\n<ul>\r\n\t<li>Quarterly reporting is based on a review of a statistically valid sample of paid and denied claims determined with a ninety-five percent (95%) confidence level, +\/- three percent (3%), assuming an error rate of three percent (3%) in the population of managed care claims.&nbsp;<\/li>\r\n\t<li>Each submeasure will have its own random sample based on the criteria in the measure.<\/li>\r\n\t<li>Sampling frequency will be quarterly.<\/li>\r\n\t<li>Determine the sample size for each submeasure utilizing a sample size calculator such as the one at the following link: <a href=\"https:\/\/urldefense.proofpoint.com\/v2\/url?u=https-3A__www.calculator.net_sample-2Dsize-2Dcalculator.html-3Ftype-3D1-26cl-3D95-26ci-3D3-26pp-3D97-26ps-3D20000-26x-3D78-26y-3D25&amp;d=DwMFAg&amp;c=c6MrceVCY5m5A_KAUkrdoA&amp;r=QHmOfen4M2numcUVeSjlkzziTX4dj5KDPoUFDtTNfrE&amp;m=grFKTjw-pVHPfmJGR3BHwAxWfuc1j62byRM2IiBn0jA&amp;s=9pNmOkrlsRqgA9jeXLLgGWQOeWoJQN50G6zwl-Uq7-4&amp;e=\">https:\/\/www.calculator.net\/sample-size-calculator.html?type=1&amp;cl=95&amp;ci=3&amp;pp=97&amp;ps=20000&amp;x=78&amp;y=25<\/a>.&nbsp; Utilize 95% for the confidence Level, 3% for the margin of error, and 97% for the population proportion.&nbsp; The population size will vary by submeasure.<\/li>\r\n\t<li>Pull the sample for each submeasure from a pool of claims that include adjusted claims, even if the original payment to the claim was made prior to the measurement period.<\/li>\r\n\t<li>Utilize the same sample for the corresponding submeasures for DENTAL_CLAIM.04, DENTAL_CLAIM.05, DENTAL_CLAIM.06.&nbsp; For example, the sample drawn for DENTAL_CLAIM.04-A should be used for DENTAL_CLAIM.05-A and DENTAL_CLAIM.06-A.&nbsp; Similarly, the sample drawn for DENTAL_CLAIM.04-C should be used for DENTAL_CLAIM.05-C and DENTAL_CLAIM.06-C, etc.<\/li>\r\n<\/ul>\r\n\r\n<p><em><strong>Note: <\/strong><\/em><\/p>\r\n\r\n<ul>\r\n\t<li><em><strong>The sampling methodology specified in the measure specifications for DENTAL_CLAIM.04, DENTAL_CLAIM.05 and DENTAL_CLAIM.06 shall remain unchanged and represents the smaller allowable sample. The DO may utilize a larger sample if they so choose, including utilizing all claims reviewed during the measurement period.<\/strong><\/em><\/li>\r\n<\/ul>","relevance":"","tech_definition_owner_id":"13","steward_id":"5","data_source":"3","rate_source":"1","rate_formula":"c:1|\/|c:2|*|100","parent_measure_id":"0","uploader_user_id":"37","submission_frequency":"3","reporting_period_min":"1680321600","reporting_period_max":"4102376400","last_modified":"1712069446","spec_id":"784","rate_precision":"1","rate_type":"1","steward_measure_id":"CLAIM.25","requirement_source":"Exhibit O","optional_exclusions":"<p>None<\/p>","comments":"","subpopulation":"0","summary_of_changes":"<p>Minor changes to the definitions.<\/p>","eligible_population":"<p>All Medicaid members age 21 and older as of the last day of the measurement period.<\/p>","period_length":"6","submission_due_date_lag":"50","lag_unit":"Days","use_case":"1","short_name":"","retired":null,"period_length_multiplier":"1","submission_frequency_multiplier":"1","acknowledgements":"","retired_reason":"","replaced_by":"","definitions":"<ul>\r\n\t<li><strong>Adjunctive (D9000-D9999)<\/strong> : Secondary treatment in addition to primary treatment. (<a href=\"https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-clinical-terms\">https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-clinical-terms<\/a>)<\/li>\r\n\t<li><strong>Diagnostic Evaluation (D0100-D0999)<\/strong>: The patient assessment that may include gathering of information through interview, observation, examination, and use of specific tests that allows a dentist to diagnose existing conditions. Please refer to specific oral evaluation code (D01xx) descriptors for more complete definitions.&nbsp; This includes periodic oral evaluations and problem-focused extensive oral evaluations. (<a href=\"https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-clinical-terms\">https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-clinical-terms<\/a>)<\/li>\r\n\t<li><strong>Implant Services (D6100)<\/strong> <strong>:<\/strong> Surgical removal of implant body.<\/li>\r\n\t<li><strong>Maxillofacial Prosthetics (D5900-D5999)<\/strong> <strong>:<\/strong> Prostheses&nbsp;or&nbsp;devices&nbsp;to&nbsp;treat&nbsp;or&nbsp;restore&nbsp;tissues&nbsp;of&nbsp;the&nbsp;stomatognathic&nbsp;system&nbsp;and&nbsp;associated&nbsp;facial&nbsp;structures&nbsp;affected&nbsp;by&nbsp;disease,&nbsp;injury,&nbsp;surgery,&nbsp;or&nbsp;congenital&nbsp;defect&nbsp;to&nbsp;provide&nbsp;all&nbsp;possible&nbsp;function&nbsp;and&nbsp;esthetics. (<a href=\"https:\/\/medical-dictionary.thefreedictionary.com\/maxillofacial+prosthetics#:~:text=Medical%20Dictionary%20for%20the%20Dental%20Professions%20%C2%A9%20Farlex%202012\">https:\/\/medical-dictionary.thefreedictionary.com\/maxillofacial+prosthetics#:~:text=Medical%20Dictionary%20for%20the%20Dental%20Professions%20%C2%A9%20Farlex%202012<\/a>)<\/li>\r\n\t<li><strong>Oral &amp; Maxillofacial Surgery (D7000-D7999):<\/strong> the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. (<a href=\"https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-administrative-terms#oo\">https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-administrative-terms#oo<\/a>)<\/li>\r\n\t<li><strong>Periodontics (D4000-D4999)<\/strong>: the specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes, and the maintenance of the health, function and esthetics of these structures and tissues. (<a href=\"https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-administrative-terms\">https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-administrative-terms<\/a>)<strong> <\/strong><\/li>\r\n\t<li><strong>Preventive dentistry (D1000-D1999)<\/strong>: Aspects of dentistry concerned with promoting good oral health and function by preventing or reducing the onset and\/or development of oral diseases or deformities and the occurrence of oro-facial injuries. (<a href=\"https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-clinical-terms#pp\">https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-clinical-terms#pp<\/a>)<\/li>\r\n\t<li><strong>Prosthodontics (D5000-D5899)<\/strong>: the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients with clinical conditions associated with missing or deficient teeth and\/or oral and maxillofacial tissues using biocompatible substitutes. (<a href=\"https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-administrative-terms#pp\">https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-administrative-terms#pp<\/a>)<\/li>\r\n\t<li><strong>Restorative (D2000-D2999): <\/strong>A restoration of any type (e.g., \u201cfilling\u201d; crown) fabricated inside the mouth. These may be interim, provisional, or temporary restorations. (<a href=\"https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-clinical-terms\">https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-clinical-terms<\/a>)\r\n\t<ul>\r\n\t\t<li><strong>Interim<\/strong>: <strong>(a)<\/strong> A restoration or prosthesis designed for use over a limited period of time; <strong>(b) <\/strong>A procedure that whose outcome is, by intent, subject to change arising from subsequent delivery of another procedure. The \u201cinterim\u201d period of time for a restoration, a prosthesis or a procedure, is determined by the clinical and professional judgment of the dentist.<\/li>\r\n\t\t<li><strong>Provisional<\/strong>: a restoration or prosthesis placed for a longer time period to enable healing, stabilization or diagnostic purposes.<\/li>\r\n\t\t<li><strong>Temporary<\/strong>: a restoration or prosthesis placed for a shorter time interval for use while a definitive restoration or prosthesis is being fabricated.<\/li>\r\n\t<\/ul>\r\n\t<\/li>\r\n<\/ul>","summarize":"0","rate_weighted":"1","frequency_name":"Quarters","period_length_name":"Quarters","data_source_name":"Professional and Facility Claims","rate_type_name":"Percent","yaxis_label":"","machine_name":"dental-claims-quality-assurance-dental-claims-payment-accuracy-1","show_mean":"0","attr_links":"<a href=\"\/measures-topic-list#dental-organization-operations\">Dental Organization Operations<\/a>","period_info":{"name":"Quarter","format":"Y-m","label_format":"M Y","diff_name":"month","diff_format":"m","diff_mult":3,"maxperiods":16}},"aggregated":true,"init":false,"org_abbrevs":{"14":"FFS (CTS)","8":"MPAP","10":"FFS-PAP","1":"NHHF","3":"WS","12":"ACNH","16":"NEDD","4":"MFFS","11":"DHHS","13":"FFS (OC)","2":"Meri"},"ci":{"Dental Claims Quality Assurance: Dental Claims Payment Accuracy":[{"lower":"91.9","upper":"93.3"},{"lower":"99.7","upper":"99.9"},{"lower":"100.0","upper":"100.0"},{"lower":"100.0","upper":"100.0"},{"lower":"100.0","upper":"100.0"},{"lower":"100.0","upper":"100.0"},null,null]},"statuses":{"Dental Claims Quality Assurance: Dental Claims Payment Accuracy":{"2023-06":{"6":"Published"},"2023-09":{"6":"Published"},"2023-12":{"6":"Published"},"2024-03":{"6":"Published"},"2024-06":{"6":"Published"},"2024-09":{"6":"Published"},"2024-12":{"6":"Published"},"2025-03":{"6":"Published"}}},"comptypes":[],"comppref":[],"compsources":[],"compsuppress":[],"compmeasures":{"2024":[{"id":"118205","identifier":"DENTAL_CLAIM.04","name":"Dental Claims Quality Assurance: Dental Claims Payment Accuracy"}]},"complines":[{"name":"Contract Requirement CY 2024","value":"97.0","type":"2","preference":">=","suppress":"0"}]}},"template_options":{"template":"allinfo","trend_graph":true,"trend_type":"line","confidence":true,"comparator_graph":true,"data_tables":true,"submitted_data":true,"comparator_data":true,"data_source":true,"relevance":true,"topics":true,"description":true,"definitions":true,"tech_def":true,"data_elements":true,"eligible":true,"summary":true,"comparator_details":true},"filename":"Dental_Claims_Quality_Assurance__Dental_Claims_Payment_Accuracy","fixed_denom":2,"comp_goal":3,"generated":"May 27 2025 at 15:45","suppression_note":"Data has been suppressed due to small sample size."}}},"#theme":"mqis_measure_report_enhanced_template","#measures":{"118205":{"xcomps":[],"ycomps":[],"complegend":[],"compdata":{"Contract Requirement":[{"name":"Contract Requirement","data_source":"Contract","data_source_order":"1","notes":"","year":"2024","year_type":"CY","measure_name":"Dental Claims Quality Assurance: Dental Claims Payment Accuracy"},{"name":"Contract Requirement","data_source":"Contract","data_source_order":"1","notes":"","year":"2024","year_type":"CY","measure_name":"Dental Claims Quality Assurance: Dental Claims Payment Accuracy"}]},"ymax":115,"comp_table":"<table class=\"table table-striped td-borders responsive-enabled\" data-striping=\"1\">\n      <caption>Dental Claims Quality Assurance: Dental Claims Payment Accuracy - Comparators <span class=\"normal\">(<a href=\"\/mqis\/reports\/csv\/comp118205\/1748375159\">Export<\/a>)<\/span><\/caption>\n  \n  \n      <thead>\n      <tr>\n                  <th class=\"hidden-column is-active\" aria-sort=\"ascending\"><a href=\"\/mqis\/reports\/measure\/118205\/ajax?sort=desc&amp;order=Original%20Order\" title=\"sort by Original Order\" rel=\"nofollow\">Original Order<span class=\"tablesort tablesort--desc\">\n  <span class=\"visually-hidden\">\n    Sort descending\n      <\/span>\n<\/span>\n<\/a><\/th>\n                  <th class=\"hidden-column\"><a href=\"\/mqis\/reports\/measure\/118205\/ajax?sort=asc&amp;order=Measure%20ID\" title=\"sort by Measure ID\" rel=\"nofollow\">Measure ID<\/a><\/th>\n                  <th><a href=\"\/mqis\/reports\/measure\/118205\/ajax?sort=asc&amp;order=Measure%20Name\" title=\"sort by Measure Name\" rel=\"nofollow\">Measure Name<\/a><\/th>\n                  <th><a href=\"\/mqis\/reports\/measure\/118205\/ajax?sort=asc&amp;order=Comparator%20Name\" title=\"sort by Comparator Name\" rel=\"nofollow\">Comparator Name<\/a><\/th>\n                  <th><a href=\"\/mqis\/reports\/measure\/118205\/ajax?sort=asc&amp;order=Comparator%20Type\" title=\"sort by Comparator Type\" rel=\"nofollow\">Comparator Type<\/a><\/th>\n                  <th class=\"hidden-column\"><a href=\"\/mqis\/reports\/measure\/118205\/ajax?sort=asc&amp;order=Year\" title=\"sort by Year\" rel=\"nofollow\">Year<\/a><\/th>\n                  <th><a href=\"\/mqis\/reports\/measure\/118205\/ajax?sort=asc&amp;order=Value\" title=\"sort by Value\" rel=\"nofollow\">Value<\/a><\/th>\n              <\/tr>\n    <\/thead>\n  \n      <tbody>\n              <tr>\n                      <td field=\"original_order\" class=\"hidden-column\">0<\/td>\n                      <td field=\"measure_identifier\" class=\"hidden-column\">DENTAL_CLAIM.04<\/td>\n                      <td field=\"measure_name\" class=\"alignleft\">Dental Claims Quality Assurance: Dental Claims Payment Accuracy<\/td>\n                      <td field=\"name\" class=\"alignleft\">Contract Requirement CY 2024<\/td>\n                      <td field=\"type\">Contract Requirement<\/td>\n                      <td field=\"comparator_year\" class=\"hidden-column\">2024<\/td>\n                      <td field=\"rate_comparator_value\">97.0<\/td>\n                  <\/tr>\n          <\/tbody>\n    <\/table>\n","xseries":{"2023-06":"Qtr2 2023","2023-09":"Qtr3 2023","2023-12":"Qtr4 2023","2024-03":"Qtr1 2024","2024-06":"Qtr2 2024","2024-09":"Qtr3 2024","2024-12":"Qtr4 2024","2025-03":"Qtr1 2025"},"yseries":{"Dental Claims Quality Assurance: Dental Claims Payment Accuracy":{"2023-06":"92.6","2023-09":"99.8","2023-12":"100.0","2024-03":"100.0","2024-06":"100.0","2024-09":"100.0","2024-12":"100.0","2025-03":"100.0"}},"trendlegend":{"Dental Claims Quality Assurance: Dental Claims Payment Accuracy":"Total (All Subgroups)"},"numerators":{"Dental Claims Quality Assurance: Dental Claims Payment Accuracy":[6414,10215,9188,13219,12859,11898,13069,14391]},"denominators":{"Dental Claims Quality Assurance: Dental Claims Payment Accuracy":[6924,10238,9189,13221,12864,11899,13069,14391]},"timeperiods":{"t_2023-04-01_2023-06-30":{"start":"1680321600","end":"1688097600"},"t_2023-07-01_2023-09-30":{"start":"1688184000","end":"1696046400"},"t_2023-10-01_2023-12-31":{"start":"1696132800","end":"1703998800"},"t_2024-01-01_2024-03-31":{"start":"1704085200","end":"1711857600"},"t_2024-04-01_2024-06-30":{"start":"1711944000","end":"1719720000"},"t_2024-07-01_2024-09-30":{"start":"1719806400","end":"1727668800"},"t_2024-10-01_2024-12-31":{"start":"1727755200","end":"1735621200"},"t_2025-01-01_2025-03-31":{"start":"1735707600","end":"1743393600"}},"data_elements":[{"data_element_id":"255903","identifier":"DENTAL_CLAIM.04-D_NUM","measure_id":"118209","type":"1","tech_definition":"<p>Total count&nbsp;of sampled <strong>Prosthodontics (Removable) Dental Claims (D5000-D5899)<\/strong> from the denominator that are paid or denied correctly during the measurement period.<\/p>\r\n\r\n<ul>\r\n\t<li>Claims with errors on two or more lines count as one claim.<\/li>\r\n<\/ul>","class":"1","uploader_user_id":"37","last_modified":"1711033945","spec_id":"784","data_element_class_name":"Numerator"},{"data_element_id":"255904","identifier":"DENTAL_CLAIM.04-D_DEN","measure_id":"118209","type":"1","tech_definition":"<p>The total count of sampled <strong>Prosthodontics (Removable) Dental Claims <\/strong>reviewed during the measurement period.<\/p>\r\n\r\n<ul>\r\n\t<li>Use CDT codes <strong>D5000-D5899<\/strong>.<\/li>\r\n\t<li>When generating the sample, each claim will count as one claim, regardless of the number of lines on the claim.<\/li>\r\n\t<li>Include adjusted claims where the adjustment occurred during the measurement period.<\/li>\r\n\t<li>Include claims partially paid during the measurement period, where at least one line is paid and one or more lines are denied.<\/li>\r\n\t<li>Exclude claims voided during the measurement period.<\/li>\r\n\t<li>If there were no claims received or reviewed for this submeasure category, submit zero as your denominator, numerator, rate and weight.<\/li>\r\n<\/ul>","class":"2","uploader_user_id":"37","last_modified":"1711563864","spec_id":"784","data_element_class_name":"Denominator"},{"data_element_id":"255905","identifier":"DENTAL_CLAIM.04-D_RATE","measure_id":"118209","type":"1","tech_definition":"<p><a href=\"http:\/\/mqis.sr.unh.edu\/mqis\/measure-details\/2843\/rate-wizard\">Numerator\/Denominator*100<\/a><br \/>\r\nData should be truncated to two decimal places. MQIS will round it up to one decimal place.<\/p>","class":"3","uploader_user_id":"37","last_modified":"1718913687","spec_id":"784","data_element_class_name":"Rate"},{"data_element_id":"255942","identifier":"DENTAL_CLAIM.04-D_WEIGHT","measure_id":"118209","type":"1","tech_definition":"<p>The total number of <strong>Prosthodontics (Removable) Dental Claims<\/strong> coming into the system for review from which the sample is drawn.<\/p>","class":"7","uploader_user_id":"37","last_modified":"1711034825","spec_id":"784","data_element_class_name":"Weight"}],"data_table":"<table class=\"table table-striped td-borders responsive-enabled\" data-striping=\"1\">\n      <caption>Dental Claims Quality Assurance: Dental Claims Payment Accuracy <span class=\"normal\">(<a href=\"\/mqis\/reports\/csv\/data118205\/1748375159\">Export<\/a>)<\/span><\/caption>\n  \n  \n      <thead>\n      <tr>\n                  <th class=\"date-range-column\">Time Period<\/th>\n                  <th>Measure Name<\/th>\n                  <th>Measure Numerator<\/th>\n                  <th>Measure Denominator<\/th>\n                  <th>Measure Rate<\/th>\n                  <th>Confidence Interval<\/th>\n              <\/tr>\n    <\/thead>\n  \n      <tbody>\n              <tr>\n                      <td>2023-04-01 - 2023-06-30<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">6,414<\/td>\n                      <td class=\"alignright\">6,924<\/td>\n                      <td class=\"alignright\">92.6%<\/td>\n                      <td>91.9 - 93.3<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2023-07-01 - 2023-09-30<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">10,215<\/td>\n                      <td class=\"alignright\">10,238<\/td>\n                      <td class=\"alignright\">99.8%<\/td>\n                      <td>99.7 - 99.9<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2023-10-01 - 2023-12-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">9,188<\/td>\n                      <td class=\"alignright\">9,189<\/td>\n                      <td class=\"alignright\">100.0%<\/td>\n                      <td>100.0 - 100.0<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2024-01-01 - 2024-03-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">13,219<\/td>\n                      <td class=\"alignright\">13,221<\/td>\n                      <td class=\"alignright\">100.0%<\/td>\n                      <td>100.0 - 100.0<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2024-04-01 - 2024-06-30<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">12,859<\/td>\n                      <td class=\"alignright\">12,864<\/td>\n                      <td class=\"alignright\">100.0%<\/td>\n                      <td>100.0 - 100.0<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2024-07-01 - 2024-09-30<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">11,898<\/td>\n                      <td class=\"alignright\">11,899<\/td>\n                      <td class=\"alignright\">100.0%<\/td>\n                      <td>100.0 - 100.0<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2024-10-01 - 2024-12-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">13,069<\/td>\n                      <td class=\"alignright\">13,069<\/td>\n                      <td class=\"alignright\">100.0%<\/td>\n                      <td>N\/A<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2025-01-01 - 2025-03-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">14,391<\/td>\n                      <td class=\"alignright\">14,391<\/td>\n                      <td class=\"alignright\">100.0%<\/td>\n                      <td>N\/A<\/td>\n                  <\/tr>\n          <\/tbody>\n    <\/table>\n","suppressed":false,"orgs":{"DMCM: Northeast Delta Dental":16},"qualifiers":{"Qtr1 2024":[],"Qtr1 2025":[],"Qtr2 2023":[],"Qtr2 2024":[],"Qtr3 2023":[],"Qtr3 2024":[],"Qtr4 2023":[],"Qtr4 2024":[]},"verifieds":{"2023-06":{"16":false},"2023-09":{"16":false},"2023-12":{"16":false},"2024-03":{"16":false},"2024-06":{"16":false},"2024-09":{"16":false},"2024-12":{"16":false},"2025-03":{"16":false}},"measure":{"measure_id":"118205","identifier":"DENTAL_CLAIM.04","name":"Dental Claims Quality Assurance: Dental Claims Payment Accuracy","description":"<p>Percent of all <strong>Dental Claims<\/strong> paid or denied correctly during the measurement period by dental category of service: A. Diagnostic; B. Preventive; C. Restorative; D. Prosthodontics (Removable); E. Oral and Maxillofacial Surgery; F. Adjunctive; G. Periodontics; H. Maxillofacial Prosthetics; I. Implant Services<\/p>\r\n\r\n<p>&nbsp;<\/p>\r\n\r\n<p><strong>Note:<\/strong> Percent is derived from the sampled dental claims.<\/p>","tech_definition":"<p>This measure is a parent measure that groups together related submeasures. Data is submitted only for submeasures. After submission of submeasure data, the system calculates the parent measure by totaling together the submitted submeasures. Each submeasure has its own measure and data element technical specifications detail. The information below provides a general technical description of the measure as a whole.<\/p>\r\n\r\n<p><strong>Submeasures:<\/strong> The measure is reported for nine submeasures: A. Diagnostic; B. Preventive; C. Restorative; D. Prosthodontics, Removable; E. Oral and Maxillofacial Surgery; F. Adjunctive; G. Periodontics; H. Maxillofacial Prosthetics; I. Implant Services<\/p>\r\n\r\n<h3><strong>Sampling:<\/strong><\/h3>\r\n\r\n<ul>\r\n\t<li>Quarterly reporting is based on a review of a statistically valid sample of paid and denied claims determined with a ninety-five percent (95%) confidence level, +\/- three percent (3%), assuming an error rate of three percent (3%) in the population of managed care claims.&nbsp;<\/li>\r\n\t<li>Each submeasure will have its own random sample based on the criteria in the measure.<\/li>\r\n\t<li>Sampling frequency will be quarterly.<\/li>\r\n\t<li>Determine the sample size for each submeasure utilizing a sample size calculator such as the one at the following link: <a href=\"https:\/\/urldefense.proofpoint.com\/v2\/url?u=https-3A__www.calculator.net_sample-2Dsize-2Dcalculator.html-3Ftype-3D1-26cl-3D95-26ci-3D3-26pp-3D97-26ps-3D20000-26x-3D78-26y-3D25&amp;d=DwMFAg&amp;c=c6MrceVCY5m5A_KAUkrdoA&amp;r=QHmOfen4M2numcUVeSjlkzziTX4dj5KDPoUFDtTNfrE&amp;m=grFKTjw-pVHPfmJGR3BHwAxWfuc1j62byRM2IiBn0jA&amp;s=9pNmOkrlsRqgA9jeXLLgGWQOeWoJQN50G6zwl-Uq7-4&amp;e=\">https:\/\/www.calculator.net\/sample-size-calculator.html?type=1&amp;cl=95&amp;ci=3&amp;pp=97&amp;ps=20000&amp;x=78&amp;y=25<\/a>.&nbsp; Utilize 95% for the confidence Level, 3% for the margin of error, and 97% for the population proportion.&nbsp; The population size will vary by submeasure.<\/li>\r\n\t<li>Pull the sample for each submeasure from a pool of claims that include adjusted claims, even if the original payment to the claim was made prior to the measurement period.<\/li>\r\n\t<li>Utilize the same sample for the corresponding submeasures for DENTAL_CLAIM.04, DENTAL_CLAIM.05, DENTAL_CLAIM.06.&nbsp; For example, the sample drawn for DENTAL_CLAIM.04-A should be used for DENTAL_CLAIM.05-A and DENTAL_CLAIM.06-A.&nbsp; Similarly, the sample drawn for DENTAL_CLAIM.04-C should be used for DENTAL_CLAIM.05-C and DENTAL_CLAIM.06-C, etc.<\/li>\r\n<\/ul>\r\n\r\n<p><em><strong>Note: <\/strong><\/em><\/p>\r\n\r\n<ul>\r\n\t<li><em><strong>The sampling methodology specified in the measure specifications for DENTAL_CLAIM.04, DENTAL_CLAIM.05 and DENTAL_CLAIM.06 shall remain unchanged and represents the smaller allowable sample. The DO may utilize a larger sample if they so choose, including utilizing all claims reviewed during the measurement period.<\/strong><\/em><\/li>\r\n<\/ul>","relevance":"","tech_definition_owner_id":"13","steward_id":"5","data_source":"3","rate_source":"1","rate_formula":"c:1|\/|c:2|*|100","parent_measure_id":"0","uploader_user_id":"37","submission_frequency":"3","reporting_period_min":"1680321600","reporting_period_max":"4102376400","last_modified":"1712069446","spec_id":"784","rate_precision":"1","rate_type":"1","steward_measure_id":"CLAIM.25","requirement_source":"Exhibit O","optional_exclusions":"<p>None<\/p>","comments":"","subpopulation":"0","summary_of_changes":"<p>Minor changes to the definitions.<\/p>","eligible_population":"<p>All Medicaid members age 21 and older as of the last day of the measurement period.<\/p>","period_length":"6","submission_due_date_lag":"50","lag_unit":"Days","use_case":"1","short_name":"","retired":null,"period_length_multiplier":"1","submission_frequency_multiplier":"1","acknowledgements":"","retired_reason":"","replaced_by":"","definitions":"<ul>\r\n\t<li><strong>Adjunctive (D9000-D9999)<\/strong> : Secondary treatment in addition to primary treatment. (<a href=\"https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-clinical-terms\">https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-clinical-terms<\/a>)<\/li>\r\n\t<li><strong>Diagnostic Evaluation (D0100-D0999)<\/strong>: The patient assessment that may include gathering of information through interview, observation, examination, and use of specific tests that allows a dentist to diagnose existing conditions. Please refer to specific oral evaluation code (D01xx) descriptors for more complete definitions.&nbsp; This includes periodic oral evaluations and problem-focused extensive oral evaluations. (<a href=\"https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-clinical-terms\">https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-clinical-terms<\/a>)<\/li>\r\n\t<li><strong>Implant Services (D6100)<\/strong> <strong>:<\/strong> Surgical removal of implant body.<\/li>\r\n\t<li><strong>Maxillofacial Prosthetics (D5900-D5999)<\/strong> <strong>:<\/strong> Prostheses&nbsp;or&nbsp;devices&nbsp;to&nbsp;treat&nbsp;or&nbsp;restore&nbsp;tissues&nbsp;of&nbsp;the&nbsp;stomatognathic&nbsp;system&nbsp;and&nbsp;associated&nbsp;facial&nbsp;structures&nbsp;affected&nbsp;by&nbsp;disease,&nbsp;injury,&nbsp;surgery,&nbsp;or&nbsp;congenital&nbsp;defect&nbsp;to&nbsp;provide&nbsp;all&nbsp;possible&nbsp;function&nbsp;and&nbsp;esthetics. (<a href=\"https:\/\/medical-dictionary.thefreedictionary.com\/maxillofacial+prosthetics#:~:text=Medical%20Dictionary%20for%20the%20Dental%20Professions%20%C2%A9%20Farlex%202012\">https:\/\/medical-dictionary.thefreedictionary.com\/maxillofacial+prosthetics#:~:text=Medical%20Dictionary%20for%20the%20Dental%20Professions%20%C2%A9%20Farlex%202012<\/a>)<\/li>\r\n\t<li><strong>Oral &amp; Maxillofacial Surgery (D7000-D7999):<\/strong> the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. (<a href=\"https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-administrative-terms#oo\">https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-administrative-terms#oo<\/a>)<\/li>\r\n\t<li><strong>Periodontics (D4000-D4999)<\/strong>: the specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes, and the maintenance of the health, function and esthetics of these structures and tissues. (<a href=\"https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-administrative-terms\">https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-administrative-terms<\/a>)<strong> <\/strong><\/li>\r\n\t<li><strong>Preventive dentistry (D1000-D1999)<\/strong>: Aspects of dentistry concerned with promoting good oral health and function by preventing or reducing the onset and\/or development of oral diseases or deformities and the occurrence of oro-facial injuries. (<a href=\"https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-clinical-terms#pp\">https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-clinical-terms#pp<\/a>)<\/li>\r\n\t<li><strong>Prosthodontics (D5000-D5899)<\/strong>: the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients with clinical conditions associated with missing or deficient teeth and\/or oral and maxillofacial tissues using biocompatible substitutes. (<a href=\"https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-administrative-terms#pp\">https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-administrative-terms#pp<\/a>)<\/li>\r\n\t<li><strong>Restorative (D2000-D2999): <\/strong>A restoration of any type (e.g., \u201cfilling\u201d; crown) fabricated inside the mouth. These may be interim, provisional, or temporary restorations. (<a href=\"https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-clinical-terms\">https:\/\/www.ada.org\/publications\/cdt\/glossary-of-dental-clinical-terms<\/a>)\r\n\t<ul>\r\n\t\t<li><strong>Interim<\/strong>: <strong>(a)<\/strong> A restoration or prosthesis designed for use over a limited period of time; <strong>(b) <\/strong>A procedure that whose outcome is, by intent, subject to change arising from subsequent delivery of another procedure. The \u201cinterim\u201d period of time for a restoration, a prosthesis or a procedure, is determined by the clinical and professional judgment of the dentist.<\/li>\r\n\t\t<li><strong>Provisional<\/strong>: a restoration or prosthesis placed for a longer time period to enable healing, stabilization or diagnostic purposes.<\/li>\r\n\t\t<li><strong>Temporary<\/strong>: a restoration or prosthesis placed for a shorter time interval for use while a definitive restoration or prosthesis is being fabricated.<\/li>\r\n\t<\/ul>\r\n\t<\/li>\r\n<\/ul>","summarize":"0","rate_weighted":"1","frequency_name":"Quarters","period_length_name":"Quarters","data_source_name":"Professional and Facility Claims","rate_type_name":"Percent","yaxis_label":"","machine_name":"dental-claims-quality-assurance-dental-claims-payment-accuracy-1","show_mean":"0","attr_links":"<a href=\"\/measures-topic-list#dental-organization-operations\">Dental Organization Operations<\/a>","period_info":{"name":"Quarter","format":"Y-m","label_format":"M Y","diff_name":"month","diff_format":"m","diff_mult":3,"maxperiods":16}},"aggregated":true,"init":false,"org_abbrevs":{"14":"FFS (CTS)","8":"MPAP","10":"FFS-PAP","1":"NHHF","3":"WS","12":"ACNH","16":"NEDD","4":"MFFS","11":"DHHS","13":"FFS (OC)","2":"Meri"},"ci":{"Dental Claims Quality Assurance: Dental Claims Payment Accuracy":[{"lower":"91.9","upper":"93.3"},{"lower":"99.7","upper":"99.9"},{"lower":"100.0","upper":"100.0"},{"lower":"100.0","upper":"100.0"},{"lower":"100.0","upper":"100.0"},{"lower":"100.0","upper":"100.0"},null,null]},"statuses":{"Dental Claims Quality Assurance: Dental Claims Payment Accuracy":{"2023-06":{"6":"Published"},"2023-09":{"6":"Published"},"2023-12":{"6":"Published"},"2024-03":{"6":"Published"},"2024-06":{"6":"Published"},"2024-09":{"6":"Published"},"2024-12":{"6":"Published"},"2025-03":{"6":"Published"}}},"comptypes":[],"comppref":[],"compsources":[],"compsuppress":[],"compmeasures":{"2024":[{"id":"118205","identifier":"DENTAL_CLAIM.04","name":"Dental Claims Quality Assurance: Dental Claims Payment Accuracy"}]},"complines":[{"name":"Contract Requirement CY 2024","value":"97.0","type":"2","preference":">=","suppress":"0"}]}},"#template_options":{"template":"allinfo","trend_graph":true,"trend_type":"line","confidence":true,"comparator_graph":true,"data_tables":true,"submitted_data":true,"comparator_data":true,"data_source":true,"relevance":true,"topics":true,"description":true,"definitions":true,"tech_def":true,"data_elements":true,"eligible":true,"summary":true,"comparator_details":true},"#filename":"Dental_Claims_Quality_Assurance__Dental_Claims_Payment_Accuracy","#description":"","#header_links":"","#footer":"<p id=\"master-export-link\"><span class=\"normal\"><a href=\"\/mqis\/reports\/csv\/full\/1748375159\">Master Export<\/a> (all data for the reported measures as a csv file)<\/span><\/p><h3 id=\"report-details\">Report Details<\/h3><p>Generated on May 27 2025 at 15:45<br \/>Measures: Dental Claims Quality Assurance: Dental Claims Payment Accuracy<br \/>Max Time Periods: 16<br \/>Organizations: All (aggregated)<br \/>Data Publish Statuses: Published<\/p><p>Citation: NH Department of Health and Human Services. 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