Claims Quality Assurance: Claims Processing Accuracy

Percent of all provider claims that are accurately processed in their entirety from both a financial and non-financial perspective during the measurement period by claim type: A. Professional Claims Excluding Behavioral Health; B. Facility Claims Excluding Behavioral Health; C. Pharmacy Point Of Service (POS) Claims; D. Non-Emergent Medical Transportation (NEMT) Claims; E. Behavioral Health Professional Claims; F. Behavioral Health Facility Claims.


Measure Identifier: CLAIM.27

Please see Report Details below for more information on selected subgroups, organizations, and aggregation.