Payment Accuracy. The Procedural Accuracy is measured as a percentage of correct payments in random sampled claims in a given period. A payment shall be deemed correct when the amount of benefits paid accurately reflects the amount of benefits payable under the plan for that claim, including no payment. The percentage shall be determined by dividing (i) the number of correctly processed claims sampled for such period by, (ii) the total number of claims processed sampled for such period. Results are provided quarterly. Penalty is based on an annual average. 98% of Claims free of payment error as related to total claims paid.
Payment Accuracy. WPS shall achieve 97% level of payment accuracy. Payment accuracy is calculated by dividing the number of claims containing no payment error by the total number of claims in a sample. Measurement shall be reported on a quarterly basis with an annual settlement.
Payment Accuracy. If Customer payment and registration information is not accurate, current, and complete and you do not notify us promptly when such information changes, we may suspend or terminate your account and refuse any use of the Services. Customer will be given notice of payment inaccuracy, either by the method specified in section 22, or by notice given each time a user logs into the Total Management Services, available at but not limited to xxxxx://xxxxxx.xxxxxxxxxxxxxxx.xxx. Once notice is given to Customer, Customer will have fifteen (15) days to update the payment information, so that Customer’s outstanding balance will be paid, before any actions may be taken to suspend or terminate Customer’s account.
Payment Accuracy. Both underpayments and overpayments are counted as payment errors. This would include claims that were paid fee for service when they should have been capitated or capitated when they should have been paid fee for service. - Financial Accuracy - total gross dollars paid correctly divided by the total of dollars audited, maintain at ninety-nine percent (99%) accuracy. - Claims Processing Accuracy - number of claims paid correctly divided by the total number of claims audited, maintain at ninety-five percent (95%) accuracy.
Payment Accuracy. Calculate and pay 98% of claims without error. Financial accuracy is defined as 50% of a participant's pre-disability income, without other disability income, or 70% of pre-disability income, including other income. $ annually
Payment Accuracy. The FEA is responsible for ensuring accuracy of payments for services.
Payment Accuracy. Percentage accuracy for each Contractor Group within each Health Board area and all Scotland comparatives. These will be based on an analysis of correcting payments for Dental, Ophthalmic and Medical, and on the checking carried out by Community Pharmacy Scotland for Pharmacy.
