Common use of Quantitative Results Clause in Contracts

Quantitative Results. i. Total number and percentage of instances in which the Billing IRO determined that the Paid Claims submitted by Parkland (Claim Submitted) differed from what should have been the correct claim (Correct Claim), regardless of the effect on the payment. ii. Total number and percentage of instances in which the Claim Submitted differed from the Correct Claim and in which such difference resulted in an Overpayment to Parkland. iii. Total dollar amount of all Overpayments in the sample. iv. Total dollar amount of Paid Claims included in the sample and the net Overpayment associated with the sample. v. Error Rate in the sample. vi. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, code submitted (e.g., DRG, CPT code, etc.), code reimbursed, allowed amount reimbursed by payor, correct code (as determined by the Billing IRO), correct allowed amount (as determined by the Billing IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the Billing IRO determined that the Paid Claims submitted by Parkland RMC (Claim Submitted) differed from what should have been the correct claim (Correct Claim), regardless of the effect on the payment. ii. Total number and percentage of instances in which the Claim Submitted differed from the Correct Claim and in which such difference resulted in an Overpayment to ParklandRMC. iii. Total dollar amount of all Overpayments in the sample. iv. Total dollar amount of Paid Claims included in the sample and the net Overpayment associated with the sample. v. Error Rate in the sample. vi. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, code submitted (e.g., DRG, CPT code, etc.), code reimbursed, allowed amount reimbursed by payor, correct code (as determined by the Billing IRO), correct allowed amount (as determined by the Billing IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the Billing IRO determined that the Paid Claims submitted by Parkland OFX (Claim Submitted) differed from what should have been the correct claim (Correct Claim), regardless of the effect on the payment. ii. Total number and percentage of instances in which the Claim Submitted differed from the Correct Claim and in which such difference resulted in an Overpayment to ParklandOrthofix. iii. Total dollar amount of all Overpayments in the sample. iv. Total dollar amount of Paid Claims included in the sample and the net Overpayment associated with the sample. v. Error Rate in the sample. vi. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, code submitted (e.g., DRG, CPT code, etc.), code reimbursed, allowed amount reimbursed by payor, correct code (as determined by the Billing IRO), correct allowed amount (as determined by the Billing IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. I. Total number and percentage of instances in which the Billing IRO determined that the Paid Claims submitted by Parkland LHC (Claim Submitted) differed from what should have been the correct claim (Correct Claim), regardless of the effect on the payment. iiII. Total number and percentage of instances in which the Claim Submitted differed from the Correct Claim and in which such difference resulted in an Overpayment to ParklandLHC. iiiIII. Total dollar amount of all Overpayments in the sample. ivIV. Total dollar amount of Paid Claims included in the sample and the net Overpayment associated with the sample. v. V. Error Rate in the sample. viVI. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, code submitted (e.g., DRG, CPT code, etc.), code reimbursed, allowed amount reimbursed by payor, correct code (as determined by the Billing IRO), correct allowed amount (as determined by the Billing IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the Billing IRO determined that the Paid Claims submitted by Parkland Maxim (Claim Submitted) differed from what should have been the correct claim (Correct Claim), regardless of the effect on the payment. ii. Total number and percentage of instances in which the Claim Submitted differed from the Correct Claim and in which such difference resulted in an Overpayment to ParklandMaxim. iii. Total dollar amount of all Overpayments in the sample. iv. Total dollar amount of Paid Claims included in the sample and the net Overpayment associated with the sample. v. Error Rate in the sample. vi. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, code submitted (e.g., DRG, CPT code, etc.), code reimbursed, allowed amount reimbursed by payor, correct code (as determined by the Billing IRO), correct allowed amount (as determined by the Billing IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.

Quantitative Results. i. Total number and percentage of instances in which the Billing IRO determined that the Paid Claims submitted by Parkland Kai Heart (Claim Submitted) differed from what should have been the correct claim (Correct Claim), regardless of the effect on the payment. ii. Total number and percentage of instances in which the Claim Submitted differed from the Correct Claim and in which such difference resulted in an Overpayment to ParklandKai Heart. iii. Total dollar amount of all Overpayments in the sample. iv. Total dollar amount of Paid Claims included in the sample and the net Overpayment associated with the sample. v. Error Rate in the sample. vi. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim: Federal health care program billed, beneficiary health insurance claim number, date of service, code submitted (e.g., DRG, CPT code, etc.), code reimbursed, allowed amount reimbursed by payor, correct code (as determined by the Billing IRO), correct allowed amount (as determined by the Billing IRO), dollar difference between allowed amount reimbursed by payor and the correct allowed amount.