| Provider Types Billing to Carriers |
Paid Claims Error Rate |
Provider Compliance Error Rate |
| Error Rate |
Projected Improper Payment Amount |
Standard Error |
95% Confidence Interval |
/
|
/
|
/
|
/
|
/
|
/
|
| Endocrinology |
13.0% |
$43,314,802 |
2.5% |
8.0% - 17.9% |
20.2% |
| Podiatry |
4.0% |
$43,685,656 |
0.5% |
3.0% - 5.1% |
18.1% |
| Diagnostic Radiology |
1.4% |
$59,245,685 |
0.3% |
0.8% - 2.0% |
12.8% |
| Physical Medicine and Rehabilitation |
8.9% |
$53,141,230 |
1.5% |
6.0% - 11.8% |
21.1% |
| Otolaryngology |
5.6% |
$39,286,923 |
1.1% |
3.5% - 7.7% |
18.1% |
| Infectious Disease |
9.7% |
$37,198,961 |
1.9% |
5.9% - 13.5% |
36.2% |
| Dermatology |
2.0% |
$32,150,663 |
0.3% |
1.3% - 2.6% |
10.6% |
| Clinical Laboratory (Billing Independently) |
1.2% |
$28,667,304 |
0.3% |
0.6% - 1.7% |
13.1% |
| Anesthesiology |
2.1% |
$27,066,376 |
0.5% |
1.1% - 3.2% |
15.0% |
| Clinical Psychologist |
6.8% |
$22,067,667 |
4.9% |
( 2.7%) - 16.3% |
21.2% |
| Optometry |
4.0% |
$20,776,278 |
1.2% |
1.7% - 6.3% |
20.2% |
| Nurse Practitioner |
4.0% |
$20,061,954 |
0.9% |
2.2% - 5.7% |
12.4% |
| Vascular Surgery |
4.4% |
$19,939,498 |
1.9% |
0.6% - 8.1% |
13.0% |
| Rheumatology |
1.9% |
$18,456,694 |
0.5% |
0.9% - 2.8% |
8.1% |
| Neurosurgery |
5.1% |
$17,505,380 |
1.7% |
1.8% - 8.4% |
35.6% |
| Independent Diagnostic Testing Facility (IDTF) |
1.1% |
$16,029,953 |
0.7% |
( 0.2%) - 2.4% |
23.9% |
| Pathology |
2.3% |
$15,507,521 |
0.9% |
0.6% - 4.0% |
14.4% |
| Medical Oncology |
1.0% |
$13,357,954 |
0.3% |
0.5% - 1.6% |
9.3% |
| Thoracic Surgery |
2.5% |
$9,992,566 |
1.1% |
0.4% - 4.6% |
12.4% |
| Critical Care (Intensivists) |
7.4% |
$9,864,928 |
2.7% |
2.1% - 12.7% |
12.2% |
| Geriatric Medicine |
11.8% |
$9,822,684 |
3.4% |
5.2% - 18.5% |
30.3% |
| Radiation Oncology |
0.7% |
$7,834,567 |
0.3% |
0.1% - 1.3% |
12.5% |
| Physician Assistant |
1.7% |
$6,531,919 |
0.5% |
0.8% - 2.6% |
16.3% |
| Pain Management |
3.8% |
$5,493,295 |
1.4% |
1.1% - 6.6% |
11.3% |
| All Provider Types With Less Than 30 Lines |
2.6% |
$5,293,391 |
0.9% |
0.7% - 4.4% |
14.7% |
| Plastic and Reconstructive Surgery |
2.6% |
$4,834,883 |
1.0% |
0.6% - 4.5% |
14.0% |
| Allergy/Immunology |
2.8% |
$4,726,848 |
1.2% |
0.3% - 5.2% |
19.9% |
| Occupational Therapist in Private Practice |
5.3% |
$4,226,087 |
2.6% |
0.2% - 10.4% |
12.6% |
| Cardiac Surgery |
1.1% |
$3,672,645 |
0.4% |
0.3% - 1.8% |
23.4% |
| Ambulatory Surgical Center |
0.2% |
$3,582,286 |
0.2% |
( 0.2%) - 0.5% |
13.5% |
| Pediatric Medicine |
5.3% |
$3,268,802 |
1.5% |
2.4% - 8.3% |
12.3% |
| Interventional Pain Management |
2.9% |
$2,391,201 |
1.6% |
( 0.2%) - 6.1% |
38.5% |
| Hematology |
1.1% |
$2,387,194 |
0.6% |
( 0.1%) - 2.3% |
10.2% |
| Osteopathic Manipulative Therapy |
5.3% |
$2,229,506 |
3.0% |
( 0.6%) - 11.2% |
41.4% |
| Audiologist (Billing Independently) |
8.3% |
$2,160,240 |
4.4% |
( 0.4%) - 16.9% |
22.2% |
| Colorectal Surgery (formerly proctology) |
2.1% |
$1,913,346 |
0.7% |
0.8% - 3.4% |
9.9% |
| Interventional Radiology |
0.6% |
$1,758,087 |
0.6% |
( 0.6%) - 1.9% |
4.8% |
| Hand Surgery |
4.3% |
$1,699,003 |
2.5% |
( 0.7%) - 9.3% |
16.2% |
| Certified Registered Nurse Anesthetist (CRNA) |
0.3% |
$1,677,976 |
0.2% |
( 0.0%) - 0.7% |
10.7% |
| Portable X-Ray Supplier (Billing Independently) |
0.3% |
$541,317 |
0.2% |
( 0.0%) - 0.7% |
13.8% |
| Multispecialty Clinic or Group Practice |
2.1% |
$369,811 |
1.4% |
( 0.6%) - 4.9% |
40.0% |
| Nuclear Medicine |
0.3% |
$341,675 |
0.1% |
0.1% - 0.5% |
9.7% |
| Clinical Nurse Specialist |
1.3% |
$334,125 |
0.9% |
( 0.4%) - 3.0% |
23.9% |
| Gynecological/Oncology |
0.3% |
$192,448 |
0.2% |
( 0.1%) - 0.7% |
0.4% |
| Public Health or Welfare Agencies (Federal, State, and local) |
0.3% |
$63,713 |
0.3% |
( 0.2%) - 0.8% |
9.9% |
| Clinical Social Worker |
0.0% |
$25,497 |
0.0% |
( 0.0%) - 0.0% |
9.9% |
| Mass Immunization Roster Billers (Mass Immunizers have to roster bill assigned claims and can only bill for immunizations) |
0.0% |
$0 |
0.0% |
0.0% - 0.0% |
12.6% |
| Radiation Therapy Centers |
0.0% |
$0 |
0.0% |
0.0% - 0.0% |
21.9% |
| All Provider Types |
5.0% |
$3,678,057,770 |
0.3% |
4.4% - 5.7% |
17.2% |
| Internal Medicine |
7.6% |
$601,424,011 |
0.5% |
6.7% - 8.5% |
19.0% |
| Cardiology |
5.1% |
$325,652,570 |
0.5% |
4.0% - 6.1% |
16.0% |
| Pulmonary Disease |
19.3% |
$291,337,094 |
10.3% |
( 0.9%) - 39.5% |
25.0% |
| Family Practice |
6.4% |
$253,401,309 |
0.5% |
5.4% - 7.5% |
19.8% |
| General Practice |
22.2% |
$212,369,460 |
6.2% |
10.2% - 34.3% |
53.2% |
| Emergency Medicine |
10.7% |
$180,887,379 |
5.0% |
0.9% - 20.6% |
19.5% |
| Obstetrics/Gynecology |
23.8% |
$136,576,170 |
13.7% |
( 3.2%) - 50.7% |
30.8% |
| General Surgery |
6.6% |
$115,182,292 |
1.4% |
3.8% - 9.4% |
18.9% |
| Orthopedic Surgery |
4.4% |
$114,135,388 |
0.6% |
3.3% - 5.5% |
16.7% |
| Nephrology |
8.3% |
$113,844,580 |
1.4% |
5.6% - 11.0% |
15.4% |
| Gastroenterology |
7.3% |
$98,157,283 |
1.3% |
4.8% - 9.8% |
15.0% |
| Hematology/Oncology |
2.4% |
$92,340,993 |
0.6% |
1.3% - 3.5% |
12.0% |
| Chiropractic |
15.3% |
$92,309,814 |
1.5% |
12.4% - 18.2% |
30.6% |
| Psychiatry |
10.7% |
$81,500,712 |
3.7% |
3.5% - 18.0% |
20.3% |
| Ambulance Service Supplier (e.g., private ambulance companies, funeral homes) |
2.3% |
$75,786,308 |
0.7% |
1.0% - 3.6% |
17.0% |
| Urology |
4.2% |
$72,463,458 |
0.7% |
2.8% - 5.6% |
13.4% |
| Physical Therapist in Private Practice |
6.1% |
$65,752,382 |
1.0% |
4.1% - 8.1% |
21.5% |
| Ophthalmology |
1.8% |
$65,405,586 |
0.3% |
1.3% - 2.3% |
11.8% |
| Neurology |
6.0% |
$64,840,444 |
0.9% |
4.1% - 7.8% |
18.4% |
|
|