| Service Types Billed to DMERCs (SADMERC Policy Group) |
Paid Claims Error Rate |
| Error Rate |
Number of Line Items (Sample) |
Projected Improper Payment Amount |
Standard Error |
95% Confidence Interval |
/
|
/
|
/
|
/
|
/
|
/
|
| Surgical Dressings |
75.7% |
195 |
$176,320,864 |
11.9% |
52.3% - 99.1% |
| Glucose Monitor |
13.6% |
2,719 |
$158,218,995 |
1.1% |
11.5% - 15.8% |
| All Policy Groups with Less than 30 Claims |
6.8% |
627 |
$109,302,255 |
2.9% |
1.2% - 12.5% |
| Nebulizers & Related Drugs |
6.0% |
2,525 |
$55,954,945 |
2.1% |
1.8% - 10.2% |
| Support Surfaces |
29.6% |
64 |
$30,749,629 |
13.5% |
3.1% - 56.1% |
| CPAP |
7.4% |
743 |
$27,821,845 |
2.5% |
2.4% - 12.3% |
| Ostomy Supplies |
16.2% |
329 |
$22,990,712 |
7.7% |
1.2% - 31.2% |
| Lower Limb Orthoses |
9.8% |
142 |
$17,429,493 |
5.1% |
( 0.1%) - 19.7% |
| Immunosuppressive Drugs |
4.9% |
221 |
$16,698,871 |
2.5% |
( 0.0%) - 9.8% |
| Oxygen Supplies/Equipment |
0.7% |
2,506 |
$14,516,566 |
0.2% |
0.2% - 1.1% |
| Diabetic Shoes |
7.2% |
189 |
$12,610,011 |
3.6% |
0.2% - 14.3% |
| Urological Supplies |
19.5% |
224 |
$10,838,330 |
8.8% |
2.1% - 36.8% |
| Wheelchairs Options/Accessories |
5.9% |
402 |
$10,422,178 |
2.9% |
0.2% - 11.5% |
| Enteral Nutrition |
1.7% |
460 |
$9,150,690 |
0.8% |
0.0% - 3.3% |
| Wheelchairs Manual |
2.5% |
624 |
$5,572,536 |
0.8% |
1.0% - 4.0% |
| Respiratory Assist Device |
3.5% |
70 |
$3,121,006 |
2.7% |
( 1.8%) - 8.9% |
| Hospital Beds/Accessories |
1.1% |
409 |
$2,831,681 |
0.7% |
( 0.2%) - 2.4% |
| Walkers |
2.5% |
174 |
$2,352,197 |
1.2% |
0.2% - 4.8% |
| Lenses |
2.4% |
360 |
$2,064,086 |
1.4% |
( 0.4%) - 5.2% |
| Patient Lift |
5.9% |
54 |
$1,744,695 |
3.5% |
( 1.1%) - 12.8% |
| Upper Limb Orthoses |
3.1% |
60 |
$838,143 |
2.2% |
( 1.1%) - 7.4% |
| Commodes/Bed Pans/Urinals |
1.7% |
90 |
$698,881 |
1.4% |
( 1.0%) - 4.5% |
| Canes/Crutches |
4.5% |
52 |
$564,786 |
4.4% |
( 4.1%) - 13.2% |
| Repairs/DME |
2.1% |
33 |
$212,720 |
2.0% |
( 1.7%) - 5.9% |
| Suction Pump |
0.4% |
35 |
$33,501 |
0.4% |
( 0.4%) - 1.1% |
| Infusion Pumps & Related Drugs |
0.0% |
165 |
N/A |
N/A |
N/A |
| Wheelchairs Seating |
0.0% |
31 |
N/A |
N/A |
N/A |
| _Routinely Denied Items_ |
N/A |
76 |
N/A |
N/A |
N/A |
| All Type of Services (Incl. Codes Not Listed) |
7.5% |
13,579 |
$693,059,615 |
1.4% |
4.8% - 10.2% |
|
|