{"#title":"Timely Professional and Facility Medical Claim Processing","#attached":{"library":["mqis\/reports"],"drupalSettings":{"mqis":{"measures":{"36163":{"xcomps":[],"ycomps":[],"complegend":[],"compdata":[],"ymax":115,"comp_table":"","xseries":{"2017-09":"Sep 2017","2017-10":"Oct 2017","2017-11":"Nov 2017","2017-12":"Dec 2017","2018-01":"Jan 2018","2018-02":"Feb 2018","2018-03":"Mar 2018","2018-04":"Apr 2018","2018-05":"May 2018","2018-06":"Jun 2018","2018-07":"Jul 2018","2018-08":"Aug 2018","2018-09":"Sep 2018","2018-10":"Oct 2018","2018-11":"Nov 2018","2018-12":"Dec 2018","2019-01":"Jan 2019","2019-02":"Feb 2019","2019-03":"Mar 2019","2019-04":"Apr 2019","2019-05":"May 2019","2019-06":"Jun 2019","2019-07":"Jul 2019","2019-08":"Aug 2019"},"yseries":{"Timely Professional and Facility Medical Claim Processing":{"2017-09":"99.3","2017-10":"98.1","2017-11":"97.8","2017-12":"98.9","2018-01":"98.8","2018-02":"94.2","2018-03":"94.9","2018-04":"96.5","2018-05":"97.4","2018-06":"94.9","2018-07":"93.7","2018-08":"93.2","2018-09":"98.5","2018-10":"98.7","2018-11":"98.3","2018-12":"98.2","2019-01":"99.2","2019-02":"98.4","2019-03":"98.5","2019-04":"99.1","2019-05":"99.5","2019-06":"99.4","2019-07":"99.2","2019-08":"98.7"}},"trendlegend":{"Timely Professional and Facility Medical Claim Processing":"Total (All Subgroups)"},"numerators":{"Timely Professional and Facility Medical Claim Processing":[206263,226480,221455,217723,237122,227660,230083,236569,250346,223907,218326,209919,228628,291890,235188,224601,282523,302754,310825,346106,337079,292619,311405,303470]},"denominators":{"Timely Professional and Facility Medical Claim Processing":[207797,230840,226463,220253,240019,241713,242396,245119,256930,235923,232951,225339,232012,295854,239198,228611,284851,307699,315469,349372,338845,294344,314068,307417]},"timeperiods":{"t_2017-09-01_2017-09-30":{"start":"1504238400","end":"1506744000"},"t_2017-10-01_2017-10-31":{"start":"1506830400","end":"1509422400"},"t_2017-11-01_2017-11-30":{"start":"1509508800","end":"1512018000"},"t_2017-12-01_2017-12-31":{"start":"1512104400","end":"1514696400"},"t_2018-01-01_2018-01-31":{"start":"1514782800","end":"1517374800"},"t_2018-02-01_2018-02-28":{"start":"1517461200","end":"1519794000"},"t_2018-03-01_2018-03-31":{"start":"1519880400","end":"1522468800"},"t_2018-04-01_2018-04-30":{"start":"1522555200","end":"1525060800"},"t_2018-05-01_2018-05-31":{"start":"1525147200","end":"1527739200"},"t_2018-06-01_2018-06-30":{"start":"1527825600","end":"1530331200"},"t_2018-07-01_2018-07-31":{"start":"1530417600","end":"1533009600"},"t_2018-08-01_2018-08-31":{"start":"1533096000","end":"1535688000"},"t_2018-09-01_2018-09-30":{"start":"1535774400","end":"1538280000"},"t_2018-10-01_2018-10-31":{"start":"1538366400","end":"1540958400"},"t_2018-11-01_2018-11-30":{"start":"1541044800","end":"1543554000"},"t_2018-12-01_2018-12-31":{"start":"1543640400","end":"1546232400"},"t_2019-01-01_2019-01-31":{"start":"1546318800","end":"1548910800"},"t_2019-02-01_2019-02-28":{"start":"1548997200","end":"1551330000"},"t_2019-03-01_2019-03-31":{"start":"1551416400","end":"1554004800"},"t_2019-04-01_2019-04-30":{"start":"1554091200","end":"1556596800"},"t_2019-05-01_2019-05-31":{"start":"1556683200","end":"1559275200"},"t_2019-06-01_2019-06-30":{"start":"1559361600","end":"1561867200"},"t_2019-07-01_2019-07-31":{"start":"1561953600","end":"1564545600"},"t_2019-08-01_2019-08-31":{"start":"1564632000","end":"1567224000"}},"data_elements":[{"data_element_id":"80667","identifier":"CLAIM.01_NUM","measure_id":"36163","type":"1","tech_definition":"<div>The count of clean professional and facility claims processed (paid or denied) within 30 calendar days of receipt, for those claims received in the measure data source time period.<\/div>\r\n\r\n<div>A clean claim is any claim that:<\/div>\r\n\r\n<ul>\r\n\t<li>Made it through the EDI edits to be either paid or denied (does not have any defect, impropriety, lack of any required substantiating documentation, or particular circumstance requiring special treatment).<\/li>\r\n<\/ul>\r\n\r\n<div>A processed claim is any claim that:<\/div>\r\n\r\n<ul>\r\n\t<li>Was<strong> <\/strong>paid or denied.<\/li>\r\n<\/ul>\r\n\r\n<div>The received date is the date a paper claim is received in the MCO\u2019s mailroom or an electronic claim is submitted.<\/div>\r\n\r\n<div>The paid date is the date a payment check or electronic funds transfer is issued to the service provider.<\/div>\r\n\r\n<div>The denied date is the date at which the MCO determines that the submitted claim is not eligible for payment.<\/div>","class":"1","uploader_user_id":"144","last_modified":"1505143207","spec_id":"353","data_element_class_name":"Numerator"},{"data_element_id":"80666","identifier":"CLAIM.01_DEN","measure_id":"36163","type":"1","tech_definition":"<p>The count of all clean professional and facility claims processed during the measure data source time period.&nbsp;<\/p>\r\n\r\n<p><strong>Note:<\/strong><\/p>\r\n\r\n<ul>\r\n\t<li><em><strong>Claims include both Medical and Behavioral Health claims.<\/strong><\/em><\/li>\r\n\t<li>The claims captured in this denominator <strong>should be retained for later use in calculating<\/strong> CLAIM.09. <strong><em>&nbsp;<\/em><\/strong><\/li>\r\n\t<li>For Claim.01 and Claim.09, adjusted claims are included only if they are originally paid and then reprocessed in the same measurement period.<\/li>\r\n<\/ul>\r\n\r\n<p><strong>Business rules: <\/strong><\/p>\r\n\r\n<ul>\r\n\t<li>The denominator for CLAIM.01 should equal the denominator for CLAIM.09 for the same measurement time period.<\/li>\r\n\t<li>The weight for CLAIM.05 should equal the weight for CLAIM.06 for the same measurement time period.<\/li>\r\n\t<li>The denominator for CLAIM.01 and the denominator for CLAIM.09 should equal the weight for CLAIM.05 and the weight for CLAIM.06 for the same measurement time period.<\/li>\r\n<\/ul>\r\n\r\n<p><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Clarifications:<\/strong><\/p>\r\n\r\n<ol>\r\n\t<li>For Claim.05 and Claim.06, the samples are pulled from a pool of measures that include adjusted claims, even if the original payment to the claim was made prior to the measurement period.<\/li>\r\n\t<li>Even though the inclusion of adjusted claims increases the overall number of claims available to sample, please use the Claim.01 and Claim.09 denominator as the weight for Claim.05 and Claim.06.<\/li>\r\n<\/ol>\r\n\r\n<p><strong>Definitions: <\/strong><\/p>\r\n\r\n<p>&nbsp;A clean claim is any claim that:<\/p>\r\n\r\n<ul>\r\n\t<li>Made it through the EDI edits to be either paid or denied (does not have any defect, impropriety, lack of any required substantiating documentation, or particular circumstance requiring special treatment).<\/li>\r\n<\/ul>\r\n\r\n<p>A processed claim is any claim that:<\/p>\r\n\r\n<ul>\r\n\t<li>Was<strong> <\/strong>paid or denied.<\/li>\r\n<\/ul>","class":"2","uploader_user_id":"57","last_modified":"1519154671","spec_id":"353","data_element_class_name":"Denominator"},{"data_element_id":"80668","identifier":"CLAIM.01_RATE","measure_id":"36163","type":"1","tech_definition":"<p><a href=\"http:\/\/mqis.sr.unh.edu\/mqis\/measure-details\/2843\/rate-wizard\">Numerator\/Denominator*100<\/a><br \/>\r\n(percent rounded to 1 decimal place)<\/p>","class":"3","uploader_user_id":"57","last_modified":"1432835822","spec_id":"353","data_element_class_name":"Rate"}],"data_table":"<table class=\"table table-striped td-borders responsive-enabled\" data-striping=\"1\">\n      <caption>Timely Professional and Facility Medical Claim Processing <span class=\"normal\">(<a href=\"\/mqis\/reports\/csv\/data36163\/1757472971\">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>2017-09-01 - 2017-09-30<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">206,263<\/td>\n                      <td class=\"alignright\">207,797<\/td>\n                      <td class=\"alignright\">99.3%<\/td>\n                      <td>99.3 - 99.3<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2017-10-01 - 2017-10-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">226,480<\/td>\n                      <td class=\"alignright\">230,840<\/td>\n                      <td class=\"alignright\">98.1%<\/td>\n                      <td>98.0 - 98.2<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2017-11-01 - 2017-11-30<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">221,455<\/td>\n                      <td class=\"alignright\">226,463<\/td>\n                      <td class=\"alignright\">97.8%<\/td>\n                      <td>97.7 - 97.9<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2017-12-01 - 2017-12-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">217,723<\/td>\n                      <td class=\"alignright\">220,253<\/td>\n                      <td class=\"alignright\">98.9%<\/td>\n                      <td>98.9 - 98.9<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2018-01-01 - 2018-01-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">237,122<\/td>\n                      <td class=\"alignright\">240,019<\/td>\n                      <td class=\"alignright\">98.8%<\/td>\n                      <td>98.8 - 98.8<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2018-02-01 - 2018-02-28<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">227,660<\/td>\n                      <td class=\"alignright\">241,713<\/td>\n                      <td class=\"alignright\">94.2%<\/td>\n                      <td>94.1 - 94.3<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2018-03-01 - 2018-03-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">230,083<\/td>\n                      <td class=\"alignright\">242,396<\/td>\n                      <td class=\"alignright\">94.9%<\/td>\n                      <td>94.8 - 95.0<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2018-04-01 - 2018-04-30<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">236,569<\/td>\n                      <td class=\"alignright\">245,119<\/td>\n                      <td class=\"alignright\">96.5%<\/td>\n                      <td>96.4 - 96.6<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2018-05-01 - 2018-05-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">250,346<\/td>\n                      <td class=\"alignright\">256,930<\/td>\n                      <td class=\"alignright\">97.4%<\/td>\n                      <td>97.3 - 97.5<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2018-06-01 - 2018-06-30<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">223,907<\/td>\n                      <td class=\"alignright\">235,923<\/td>\n                      <td class=\"alignright\">94.9%<\/td>\n                      <td>94.8 - 95.0<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2018-07-01 - 2018-07-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">218,326<\/td>\n                      <td class=\"alignright\">232,951<\/td>\n                      <td class=\"alignright\">93.7%<\/td>\n                      <td>93.6 - 93.8<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2018-08-01 - 2018-08-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">209,919<\/td>\n                      <td class=\"alignright\">225,339<\/td>\n                      <td class=\"alignright\">93.2%<\/td>\n                      <td>93.1 - 93.3<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2018-09-01 - 2018-09-30<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">228,628<\/td>\n                      <td class=\"alignright\">232,012<\/td>\n                      <td class=\"alignright\">98.5%<\/td>\n                      <td>98.5 - 98.5<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2018-10-01 - 2018-10-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">291,890<\/td>\n                      <td class=\"alignright\">295,854<\/td>\n                      <td class=\"alignright\">98.7%<\/td>\n                      <td>98.7 - 98.7<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2018-11-01 - 2018-11-30<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">235,188<\/td>\n                      <td class=\"alignright\">239,198<\/td>\n                      <td class=\"alignright\">98.3%<\/td>\n                      <td>98.2 - 98.4<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2018-12-01 - 2018-12-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">224,601<\/td>\n                      <td class=\"alignright\">228,611<\/td>\n                      <td class=\"alignright\">98.2%<\/td>\n                      <td>98.1 - 98.3<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2019-01-01 - 2019-01-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">282,523<\/td>\n                      <td class=\"alignright\">284,851<\/td>\n                      <td class=\"alignright\">99.2%<\/td>\n                      <td>99.2 - 99.2<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2019-02-01 - 2019-02-28<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">302,754<\/td>\n                      <td class=\"alignright\">307,699<\/td>\n                      <td class=\"alignright\">98.4%<\/td>\n                      <td>98.4 - 98.4<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2019-03-01 - 2019-03-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">310,825<\/td>\n                      <td class=\"alignright\">315,469<\/td>\n                      <td class=\"alignright\">98.5%<\/td>\n                      <td>98.5 - 98.5<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2019-04-01 - 2019-04-30<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">346,106<\/td>\n                      <td class=\"alignright\">349,372<\/td>\n                      <td class=\"alignright\">99.1%<\/td>\n                      <td>99.1 - 99.1<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2019-05-01 - 2019-05-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">337,079<\/td>\n                      <td class=\"alignright\">338,845<\/td>\n                      <td class=\"alignright\">99.5%<\/td>\n                      <td>99.5 - 99.5<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2019-06-01 - 2019-06-30<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">292,619<\/td>\n                      <td class=\"alignright\">294,344<\/td>\n                      <td class=\"alignright\">99.4%<\/td>\n                      <td>99.4 - 99.4<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2019-07-01 - 2019-07-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">311,405<\/td>\n                      <td class=\"alignright\">314,068<\/td>\n                      <td class=\"alignright\">99.2%<\/td>\n                      <td>99.2 - 99.2<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2019-08-01 - 2019-08-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">303,470<\/td>\n                      <td class=\"alignright\">307,417<\/td>\n                      <td class=\"alignright\">98.7%<\/td>\n                      <td>98.7 - 98.7<\/td>\n                  <\/tr>\n          <\/tbody>\n    <\/table>\n","suppressed":false,"orgs":{"MCM: AmeriHealth Caritas NH":12,"MCM: NH Healthy Families":1,"MCM: Well Sense":3,"MCM: Meridian":2},"qualifiers":{"Apr 2018":[],"Apr 2019":[],"Aug 2018":[],"Aug 2019":[],"Dec 2017":[],"Dec 2018":[],"Feb 2018":[],"Feb 2019":[],"Jan 2018":[],"Jan 2019":[],"Jul 2018":[],"Jul 2019":[],"Jun 2018":[],"Jun 2019":[],"Mar 2018":[],"Mar 2019":[],"May 2018":[],"May 2019":[],"Nov 2017":[],"Nov 2018":[],"Oct 2017":[],"Oct 2018":[],"Sep 2017":[],"Sep 2018":[],"":["The aggregated values do not include data for all organizations. Customize this report by organization for details."]},"verifieds":{"2017-09":{"3":false,"1":false},"2017-10":{"3":false,"1":false},"2017-11":{"3":false,"1":false},"2017-12":{"3":false,"1":false},"2018-01":{"1":false,"3":false},"2018-02":{"1":false,"3":false},"2018-03":{"3":false,"1":false},"2018-04":{"3":false,"1":false},"2018-05":{"3":false,"1":false},"2018-06":{"3":true,"1":false},"2018-07":{"3":false,"1":false},"2018-08":{"3":true,"1":false},"2018-09":{"3":false,"1":false},"2018-10":{"3":false,"1":true},"2018-11":{"3":false,"1":false},"2018-12":{"3":false,"1":false},"2019-01":{"3":false,"1":false},"2019-02":{"3":false,"1":false},"2019-03":{"3":false,"1":false},"2019-04":{"3":false,"1":false},"2019-05":{"3":false,"1":false},"2019-06":{"3":false,"1":false},"2019-07":{"1":false,"3":false},"2019-08":{"3":false,"1":false}},"measure":{"measure_id":"36163","identifier":"CLAIM.01","name":"Timely Professional and Facility Medical Claim Processing","description":"<p>The percentage of clean professional and facility claims processed (paid or denied) within 30 calendar days of receipt, for those claims received in the measure data source time period. For example, if the measure data source time period is July, claims with receipt dates in July are examined to see what percentage of them have been paid within 30 days of the receipt date.&nbsp; (e.g, claims received on July 1 and processed by July 31, claims received on July 31 and processed by August 30).&nbsp; The data submission lag of 50 days allows for a minimum of 20 days for calculation and submission of the data.<\/p>\r\n\r\n<p><em><strong>Note: Claims include both Medical and Behavioral Health claims.<\/strong><\/em><\/p>","tech_definition":"<p>Numerator, denominator, and rate are calculated per data element specifications.<\/p>\r\n\r\n<p><strong>Note:<\/strong><\/p>\r\n\r\n<ul>\r\n\t<li>The claims captured in the denominator for CLAIM.01 should be retained for later use in the calculation of CLAIM.09 for the same measurement time period.<\/li>\r\n\t<li>For Claim.01 and Claim.09, adjusted claims are included only if they are originally paid and then reprocessed in the same measurement period.<\/li>\r\n\t<li><em><strong>Claims include both Medical and Behavioral Health claims.<\/strong><\/em><\/li>\r\n<\/ul>","relevance":"<p>Paying claims within 30 days is an important component of a good provider service experience. Claims must be \u201cclean\u201d of any inaccuracies in order to pay. A falling number of claims processed within 30 days could impact how quickly providers receive payment.&nbsp; The MCM contract standard for this measure is 95%. This measure describes the number of claims paid or denied in the month, divided by the number of claims received in the month, as a percentage.<\/p>","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":"56","submission_frequency":"2","reporting_period_min":"1483246800","reporting_period_max":"4102376400","last_modified":"1572985290","spec_id":"353","rate_precision":"1","rate_type":"1","steward_measure_id":"CLAIM.01","requirement_source":"Exhibit O","optional_exclusions":"<p>None<\/p>","comments":"","subpopulation":"0","summary_of_changes":"<div>The definition of claim is clarified throughout the specification, where claims include both medical and behavioral health claims.<\/div>\r\n\r\n<div>The definitions of clean claim and processed claim were clarified.<\/div>\r\n\r\n<div>An expanded business rule was added to the data element definitions<\/div>","eligible_population":"<p>All Medicaid members<\/p>","period_length":"7","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":"","summarize":"0","rate_weighted":"0","frequency_name":"Months","period_length_name":"Months","data_source_name":"Professional and Facility Claims","rate_type_name":"Percent","yaxis_label":"","machine_name":"timely-professional-and-facility-medical-claim-processing","show_mean":"0","attr_links":"<a href=\"\/measures-topic-list#provider-services\">Provider Services<\/a>","period_info":{"name":"Month","format":"Y-m","label_format":"M Y","diff_name":"month","diff_format":"m","diff_mult":"1","maxperiods":24}},"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":{"Timely Professional and Facility Medical Claim Processing":[{"lower":"99.3","upper":"99.3"},{"lower":"98.0","upper":"98.2"},{"lower":"97.7","upper":"97.9"},{"lower":"98.9","upper":"98.9"},{"lower":"98.8","upper":"98.8"},{"lower":"94.1","upper":"94.3"},{"lower":"94.8","upper":"95.0"},{"lower":"96.4","upper":"96.6"},{"lower":"97.3","upper":"97.5"},{"lower":"94.8","upper":"95.0"},{"lower":"93.6","upper":"93.8"},{"lower":"93.1","upper":"93.3"},{"lower":"98.5","upper":"98.5"},{"lower":"98.7","upper":"98.7"},{"lower":"98.2","upper":"98.4"},{"lower":"98.1","upper":"98.3"},{"lower":"99.2","upper":"99.2"},{"lower":"98.4","upper":"98.4"},{"lower":"98.5","upper":"98.5"},{"lower":"99.1","upper":"99.1"},{"lower":"99.5","upper":"99.5"},{"lower":"99.4","upper":"99.4"},{"lower":"99.2","upper":"99.2"},{"lower":"98.7","upper":"98.7"}]},"statuses":{"Timely Professional and Facility Medical Claim Processing":{"2017-09":{"6":"Published"},"2017-10":{"6":"Published"},"2017-11":{"6":"Published"},"2017-12":{"6":"Published"},"2018-01":{"6":"Published"},"2018-02":{"6":"Published"},"2018-03":{"6":"Published"},"2018-04":{"6":"Published"},"2018-05":{"6":"Published"},"2018-06":{"6":"Published"},"2018-07":{"6":"Published"},"2018-08":{"6":"Published"},"2018-09":{"6":"Published"},"2018-10":{"6":"Published"},"2018-11":{"6":"Published"},"2018-12":{"6":"Published"},"2019-01":{"6":"Published"},"2019-02":{"6":"Published"},"2019-03":{"6":"Published"},"2019-04":{"6":"Published"},"2019-05":{"6":"Published"},"2019-06":{"6":"Published"},"2019-07":{"6":"Published"},"2019-08":{"6":"Published"}}}}},"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":"Timely_Professional_and_Facility_Medical_Claim_Processing","fixed_denom":2,"comp_goal":3,"generated":"Sep 09 2025 at 22:56","suppression_note":"Data has been suppressed due to small sample size."}}},"#theme":"mqis_measure_report_enhanced_template","#measures":{"36163":{"xcomps":[],"ycomps":[],"complegend":[],"compdata":[],"ymax":115,"comp_table":"","xseries":{"2017-09":"Sep 2017","2017-10":"Oct 2017","2017-11":"Nov 2017","2017-12":"Dec 2017","2018-01":"Jan 2018","2018-02":"Feb 2018","2018-03":"Mar 2018","2018-04":"Apr 2018","2018-05":"May 2018","2018-06":"Jun 2018","2018-07":"Jul 2018","2018-08":"Aug 2018","2018-09":"Sep 2018","2018-10":"Oct 2018","2018-11":"Nov 2018","2018-12":"Dec 2018","2019-01":"Jan 2019","2019-02":"Feb 2019","2019-03":"Mar 2019","2019-04":"Apr 2019","2019-05":"May 2019","2019-06":"Jun 2019","2019-07":"Jul 2019","2019-08":"Aug 2019"},"yseries":{"Timely Professional and Facility Medical Claim Processing":{"2017-09":"99.3","2017-10":"98.1","2017-11":"97.8","2017-12":"98.9","2018-01":"98.8","2018-02":"94.2","2018-03":"94.9","2018-04":"96.5","2018-05":"97.4","2018-06":"94.9","2018-07":"93.7","2018-08":"93.2","2018-09":"98.5","2018-10":"98.7","2018-11":"98.3","2018-12":"98.2","2019-01":"99.2","2019-02":"98.4","2019-03":"98.5","2019-04":"99.1","2019-05":"99.5","2019-06":"99.4","2019-07":"99.2","2019-08":"98.7"}},"trendlegend":{"Timely Professional and Facility Medical Claim Processing":"Total (All Subgroups)"},"numerators":{"Timely Professional and Facility Medical Claim Processing":[206263,226480,221455,217723,237122,227660,230083,236569,250346,223907,218326,209919,228628,291890,235188,224601,282523,302754,310825,346106,337079,292619,311405,303470]},"denominators":{"Timely Professional and Facility Medical Claim Processing":[207797,230840,226463,220253,240019,241713,242396,245119,256930,235923,232951,225339,232012,295854,239198,228611,284851,307699,315469,349372,338845,294344,314068,307417]},"timeperiods":{"t_2017-09-01_2017-09-30":{"start":"1504238400","end":"1506744000"},"t_2017-10-01_2017-10-31":{"start":"1506830400","end":"1509422400"},"t_2017-11-01_2017-11-30":{"start":"1509508800","end":"1512018000"},"t_2017-12-01_2017-12-31":{"start":"1512104400","end":"1514696400"},"t_2018-01-01_2018-01-31":{"start":"1514782800","end":"1517374800"},"t_2018-02-01_2018-02-28":{"start":"1517461200","end":"1519794000"},"t_2018-03-01_2018-03-31":{"start":"1519880400","end":"1522468800"},"t_2018-04-01_2018-04-30":{"start":"1522555200","end":"1525060800"},"t_2018-05-01_2018-05-31":{"start":"1525147200","end":"1527739200"},"t_2018-06-01_2018-06-30":{"start":"1527825600","end":"1530331200"},"t_2018-07-01_2018-07-31":{"start":"1530417600","end":"1533009600"},"t_2018-08-01_2018-08-31":{"start":"1533096000","end":"1535688000"},"t_2018-09-01_2018-09-30":{"start":"1535774400","end":"1538280000"},"t_2018-10-01_2018-10-31":{"start":"1538366400","end":"1540958400"},"t_2018-11-01_2018-11-30":{"start":"1541044800","end":"1543554000"},"t_2018-12-01_2018-12-31":{"start":"1543640400","end":"1546232400"},"t_2019-01-01_2019-01-31":{"start":"1546318800","end":"1548910800"},"t_2019-02-01_2019-02-28":{"start":"1548997200","end":"1551330000"},"t_2019-03-01_2019-03-31":{"start":"1551416400","end":"1554004800"},"t_2019-04-01_2019-04-30":{"start":"1554091200","end":"1556596800"},"t_2019-05-01_2019-05-31":{"start":"1556683200","end":"1559275200"},"t_2019-06-01_2019-06-30":{"start":"1559361600","end":"1561867200"},"t_2019-07-01_2019-07-31":{"start":"1561953600","end":"1564545600"},"t_2019-08-01_2019-08-31":{"start":"1564632000","end":"1567224000"}},"data_elements":[{"data_element_id":"80667","identifier":"CLAIM.01_NUM","measure_id":"36163","type":"1","tech_definition":"<div>The count of clean professional and facility claims processed (paid or denied) within 30 calendar days of receipt, for those claims received in the measure data source time period.<\/div>\r\n\r\n<div>A clean claim is any claim that:<\/div>\r\n\r\n<ul>\r\n\t<li>Made it through the EDI edits to be either paid or denied (does not have any defect, impropriety, lack of any required substantiating documentation, or particular circumstance requiring special treatment).<\/li>\r\n<\/ul>\r\n\r\n<div>A processed claim is any claim that:<\/div>\r\n\r\n<ul>\r\n\t<li>Was<strong> <\/strong>paid or denied.<\/li>\r\n<\/ul>\r\n\r\n<div>The received date is the date a paper claim is received in the MCO\u2019s mailroom or an electronic claim is submitted.<\/div>\r\n\r\n<div>The paid date is the date a payment check or electronic funds transfer is issued to the service provider.<\/div>\r\n\r\n<div>The denied date is the date at which the MCO determines that the submitted claim is not eligible for payment.<\/div>","class":"1","uploader_user_id":"144","last_modified":"1505143207","spec_id":"353","data_element_class_name":"Numerator"},{"data_element_id":"80666","identifier":"CLAIM.01_DEN","measure_id":"36163","type":"1","tech_definition":"<p>The count of all clean professional and facility claims processed during the measure data source time period.&nbsp;<\/p>\r\n\r\n<p><strong>Note:<\/strong><\/p>\r\n\r\n<ul>\r\n\t<li><em><strong>Claims include both Medical and Behavioral Health claims.<\/strong><\/em><\/li>\r\n\t<li>The claims captured in this denominator <strong>should be retained for later use in calculating<\/strong> CLAIM.09. <strong><em>&nbsp;<\/em><\/strong><\/li>\r\n\t<li>For Claim.01 and Claim.09, adjusted claims are included only if they are originally paid and then reprocessed in the same measurement period.<\/li>\r\n<\/ul>\r\n\r\n<p><strong>Business rules: <\/strong><\/p>\r\n\r\n<ul>\r\n\t<li>The denominator for CLAIM.01 should equal the denominator for CLAIM.09 for the same measurement time period.<\/li>\r\n\t<li>The weight for CLAIM.05 should equal the weight for CLAIM.06 for the same measurement time period.<\/li>\r\n\t<li>The denominator for CLAIM.01 and the denominator for CLAIM.09 should equal the weight for CLAIM.05 and the weight for CLAIM.06 for the same measurement time period.<\/li>\r\n<\/ul>\r\n\r\n<p><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Clarifications:<\/strong><\/p>\r\n\r\n<ol>\r\n\t<li>For Claim.05 and Claim.06, the samples are pulled from a pool of measures that include adjusted claims, even if the original payment to the claim was made prior to the measurement period.<\/li>\r\n\t<li>Even though the inclusion of adjusted claims increases the overall number of claims available to sample, please use the Claim.01 and Claim.09 denominator as the weight for Claim.05 and Claim.06.<\/li>\r\n<\/ol>\r\n\r\n<p><strong>Definitions: <\/strong><\/p>\r\n\r\n<p>&nbsp;A clean claim is any claim that:<\/p>\r\n\r\n<ul>\r\n\t<li>Made it through the EDI edits to be either paid or denied (does not have any defect, impropriety, lack of any required substantiating documentation, or particular circumstance requiring special treatment).<\/li>\r\n<\/ul>\r\n\r\n<p>A processed claim is any claim that:<\/p>\r\n\r\n<ul>\r\n\t<li>Was<strong> <\/strong>paid or denied.<\/li>\r\n<\/ul>","class":"2","uploader_user_id":"57","last_modified":"1519154671","spec_id":"353","data_element_class_name":"Denominator"},{"data_element_id":"80668","identifier":"CLAIM.01_RATE","measure_id":"36163","type":"1","tech_definition":"<p><a href=\"http:\/\/mqis.sr.unh.edu\/mqis\/measure-details\/2843\/rate-wizard\">Numerator\/Denominator*100<\/a><br \/>\r\n(percent rounded to 1 decimal place)<\/p>","class":"3","uploader_user_id":"57","last_modified":"1432835822","spec_id":"353","data_element_class_name":"Rate"}],"data_table":"<table class=\"table table-striped td-borders responsive-enabled\" data-striping=\"1\">\n      <caption>Timely Professional and Facility Medical Claim Processing <span class=\"normal\">(<a href=\"\/mqis\/reports\/csv\/data36163\/1757472971\">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>2017-09-01 - 2017-09-30<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">206,263<\/td>\n                      <td class=\"alignright\">207,797<\/td>\n                      <td class=\"alignright\">99.3%<\/td>\n                      <td>99.3 - 99.3<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2017-10-01 - 2017-10-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">226,480<\/td>\n                      <td class=\"alignright\">230,840<\/td>\n                      <td class=\"alignright\">98.1%<\/td>\n                      <td>98.0 - 98.2<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2017-11-01 - 2017-11-30<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">221,455<\/td>\n                      <td class=\"alignright\">226,463<\/td>\n                      <td class=\"alignright\">97.8%<\/td>\n                      <td>97.7 - 97.9<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2017-12-01 - 2017-12-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">217,723<\/td>\n                      <td class=\"alignright\">220,253<\/td>\n                      <td class=\"alignright\">98.9%<\/td>\n                      <td>98.9 - 98.9<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2018-01-01 - 2018-01-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">237,122<\/td>\n                      <td class=\"alignright\">240,019<\/td>\n                      <td class=\"alignright\">98.8%<\/td>\n                      <td>98.8 - 98.8<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2018-02-01 - 2018-02-28<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">227,660<\/td>\n                      <td class=\"alignright\">241,713<\/td>\n                      <td class=\"alignright\">94.2%<\/td>\n                      <td>94.1 - 94.3<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2018-03-01 - 2018-03-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">230,083<\/td>\n                      <td class=\"alignright\">242,396<\/td>\n                      <td class=\"alignright\">94.9%<\/td>\n                      <td>94.8 - 95.0<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2018-04-01 - 2018-04-30<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">236,569<\/td>\n                      <td class=\"alignright\">245,119<\/td>\n                      <td class=\"alignright\">96.5%<\/td>\n                      <td>96.4 - 96.6<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2018-05-01 - 2018-05-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">250,346<\/td>\n                      <td class=\"alignright\">256,930<\/td>\n                      <td class=\"alignright\">97.4%<\/td>\n                      <td>97.3 - 97.5<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2018-06-01 - 2018-06-30<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">223,907<\/td>\n                      <td class=\"alignright\">235,923<\/td>\n                      <td class=\"alignright\">94.9%<\/td>\n                      <td>94.8 - 95.0<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2018-07-01 - 2018-07-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">218,326<\/td>\n                      <td class=\"alignright\">232,951<\/td>\n                      <td class=\"alignright\">93.7%<\/td>\n                      <td>93.6 - 93.8<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2018-08-01 - 2018-08-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">209,919<\/td>\n                      <td class=\"alignright\">225,339<\/td>\n                      <td class=\"alignright\">93.2%<\/td>\n                      <td>93.1 - 93.3<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2018-09-01 - 2018-09-30<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">228,628<\/td>\n                      <td class=\"alignright\">232,012<\/td>\n                      <td class=\"alignright\">98.5%<\/td>\n                      <td>98.5 - 98.5<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2018-10-01 - 2018-10-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">291,890<\/td>\n                      <td class=\"alignright\">295,854<\/td>\n                      <td class=\"alignright\">98.7%<\/td>\n                      <td>98.7 - 98.7<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2018-11-01 - 2018-11-30<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">235,188<\/td>\n                      <td class=\"alignright\">239,198<\/td>\n                      <td class=\"alignright\">98.3%<\/td>\n                      <td>98.2 - 98.4<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2018-12-01 - 2018-12-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">224,601<\/td>\n                      <td class=\"alignright\">228,611<\/td>\n                      <td class=\"alignright\">98.2%<\/td>\n                      <td>98.1 - 98.3<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2019-01-01 - 2019-01-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">282,523<\/td>\n                      <td class=\"alignright\">284,851<\/td>\n                      <td class=\"alignright\">99.2%<\/td>\n                      <td>99.2 - 99.2<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2019-02-01 - 2019-02-28<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">302,754<\/td>\n                      <td class=\"alignright\">307,699<\/td>\n                      <td class=\"alignright\">98.4%<\/td>\n                      <td>98.4 - 98.4<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2019-03-01 - 2019-03-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">310,825<\/td>\n                      <td class=\"alignright\">315,469<\/td>\n                      <td class=\"alignright\">98.5%<\/td>\n                      <td>98.5 - 98.5<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2019-04-01 - 2019-04-30<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">346,106<\/td>\n                      <td class=\"alignright\">349,372<\/td>\n                      <td class=\"alignright\">99.1%<\/td>\n                      <td>99.1 - 99.1<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2019-05-01 - 2019-05-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">337,079<\/td>\n                      <td class=\"alignright\">338,845<\/td>\n                      <td class=\"alignright\">99.5%<\/td>\n                      <td>99.5 - 99.5<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2019-06-01 - 2019-06-30<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">292,619<\/td>\n                      <td class=\"alignright\">294,344<\/td>\n                      <td class=\"alignright\">99.4%<\/td>\n                      <td>99.4 - 99.4<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2019-07-01 - 2019-07-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">311,405<\/td>\n                      <td class=\"alignright\">314,068<\/td>\n                      <td class=\"alignright\">99.2%<\/td>\n                      <td>99.2 - 99.2<\/td>\n                  <\/tr>\n              <tr>\n                      <td>2019-08-01 - 2019-08-31<\/td>\n                      <td class=\"alignleft\">Total (All Subgroups)<\/td>\n                      <td class=\"alignright\">303,470<\/td>\n                      <td class=\"alignright\">307,417<\/td>\n                      <td class=\"alignright\">98.7%<\/td>\n                      <td>98.7 - 98.7<\/td>\n                  <\/tr>\n          <\/tbody>\n    <\/table>\n","suppressed":false,"orgs":{"MCM: AmeriHealth Caritas NH":12,"MCM: NH Healthy Families":1,"MCM: Well Sense":3,"MCM: Meridian":2},"qualifiers":{"Apr 2018":[],"Apr 2019":[],"Aug 2018":[],"Aug 2019":[],"Dec 2017":[],"Dec 2018":[],"Feb 2018":[],"Feb 2019":[],"Jan 2018":[],"Jan 2019":[],"Jul 2018":[],"Jul 2019":[],"Jun 2018":[],"Jun 2019":[],"Mar 2018":[],"Mar 2019":[],"May 2018":[],"May 2019":[],"Nov 2017":[],"Nov 2018":[],"Oct 2017":[],"Oct 2018":[],"Sep 2017":[],"Sep 2018":[],"":["The aggregated values do not include data for all organizations. Customize this report by organization for details."]},"verifieds":{"2017-09":{"3":false,"1":false},"2017-10":{"3":false,"1":false},"2017-11":{"3":false,"1":false},"2017-12":{"3":false,"1":false},"2018-01":{"1":false,"3":false},"2018-02":{"1":false,"3":false},"2018-03":{"3":false,"1":false},"2018-04":{"3":false,"1":false},"2018-05":{"3":false,"1":false},"2018-06":{"3":true,"1":false},"2018-07":{"3":false,"1":false},"2018-08":{"3":true,"1":false},"2018-09":{"3":false,"1":false},"2018-10":{"3":false,"1":true},"2018-11":{"3":false,"1":false},"2018-12":{"3":false,"1":false},"2019-01":{"3":false,"1":false},"2019-02":{"3":false,"1":false},"2019-03":{"3":false,"1":false},"2019-04":{"3":false,"1":false},"2019-05":{"3":false,"1":false},"2019-06":{"3":false,"1":false},"2019-07":{"1":false,"3":false},"2019-08":{"3":false,"1":false}},"measure":{"measure_id":"36163","identifier":"CLAIM.01","name":"Timely Professional and Facility Medical Claim Processing","description":"<p>The percentage of clean professional and facility claims processed (paid or denied) within 30 calendar days of receipt, for those claims received in the measure data source time period. For example, if the measure data source time period is July, claims with receipt dates in July are examined to see what percentage of them have been paid within 30 days of the receipt date.&nbsp; (e.g, claims received on July 1 and processed by July 31, claims received on July 31 and processed by August 30).&nbsp; The data submission lag of 50 days allows for a minimum of 20 days for calculation and submission of the data.<\/p>\r\n\r\n<p><em><strong>Note: Claims include both Medical and Behavioral Health claims.<\/strong><\/em><\/p>","tech_definition":"<p>Numerator, denominator, and rate are calculated per data element specifications.<\/p>\r\n\r\n<p><strong>Note:<\/strong><\/p>\r\n\r\n<ul>\r\n\t<li>The claims captured in the denominator for CLAIM.01 should be retained for later use in the calculation of CLAIM.09 for the same measurement time period.<\/li>\r\n\t<li>For Claim.01 and Claim.09, adjusted claims are included only if they are originally paid and then reprocessed in the same measurement period.<\/li>\r\n\t<li><em><strong>Claims include both Medical and Behavioral Health claims.<\/strong><\/em><\/li>\r\n<\/ul>","relevance":"<p>Paying claims within 30 days is an important component of a good provider service experience. Claims must be \u201cclean\u201d of any inaccuracies in order to pay. A falling number of claims processed within 30 days could impact how quickly providers receive payment.&nbsp; The MCM contract standard for this measure is 95%. 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