Carriers |
Paid Claims Error Rate |
Type of Error |
No Documentation |
Insufficient Documentation |
Medically Unnecessary Services |
Incorrect Coding |
Other |
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Triple S, Inc. PR/VI 00973/00974 |
14.5% |
0.3% |
2.4% |
0.9% |
10.8% |
0.0% |
First Coast Service Options FL 00590 |
11.9% |
7.1% |
2.3% |
0.1% |
2.4% |
0.0% |
GHI NY 14330 |
6.8% |
0.4% |
3.3% |
0.2% |
2.8% |
0.1% |
Empire NJ 00805 |
5.6% |
0.3% |
1.6% |
0.1% |
3.6% |
0.0% |
Empire NY 00803 |
5.1% |
0.2% |
1.6% |
0.1% |
3.1% |
0.1% |
BCBS AR RI 00524 |
5.0% |
0.2% |
1.3% |
0.5% |
2.9% |
0.2% |
Cahaba AL/GA/MS 00510/00511/00512 |
5.0% |
0.5% |
1.2% |
0.3% |
2.6% |
0.5% |
Trailblazer TX 00900 |
4.8% |
0.7% |
1.3% |
0.4% |
2.3% |
0.1% |
Regence UT 00823 |
4.6% |
0.5% |
2.3% |
0.2% |
1.7% |
0.0% |
Palmetto OH/WV 00883/00884 |
4.6% |
0.5% |
1.5% |
0.0% |
2.5% |
0.0% |
Noridian AK/AZ/HI/NV/OR/WA 00831/00832/00833/00834/00835/008 |
4.3% |
0.2% |
1.5% |
0.2% |
2.4% |
0.0% |
AdminaStar IN/KY 00630/00660 |
4.3% |
1.2% |
0.7% |
0.4% |
2.1% |
0.0% |
WPS WI/IL/MI/MN 00951/00952/00953/00954 |
4.3% |
0.6% |
1.5% |
0.1% |
2.0% |
0.1% |
BCBS AR AR/NM/OK/MO/LA 00520/00521/00522/00523/00528 |
4.1% |
0.6% |
1.1% |
0.2% |
2.2% |
0.1% |
Palmetto SC 00880 |
4.1% |
0.5% |
1.3% |
0.1% |
2.2% |
0.0% |
NHIC ME/MA/NH/VT 31142/31143/31144/31145 |
3.9% |
0.4% |
0.9% |
0.0% |
2.6% |
0.0% |
First Coast Service Options CT 00591 |
3.7% |
0.2% |
1.2% |
0.1% |
2.1% |
0.1% |
NHIC CA 31140/31146 |
3.7% |
0.4% |
0.6% |
0.1% |
2.3% |
0.2% |
Trailblazer MD/DE/DC/VA 00901/00902/00903/00904 |
3.5% |
0.2% |
0.8% |
0.1% |
2.4% |
0.0% |
CIGNA NC 05535 |
3.3% |
0.1% |
1.2% |
0.1% |
1.7% |
0.3% |
HealthNow NY 00801 |
3.2% |
0.2% |
1.1% |
0.1% |
1.7% |
0.0% |
HGSA PA 00865 |
3.1% |
0.2% |
0.7% |
0.0% |
2.2% |
0.0% |
BCBS MT 00751 |
3.1% |
0.3% |
1.5% |
0.2% |
1.1% |
0.1% |
CIGNA TN 05440 |
2.9% |
0.2% |
1.0% |
0.1% |
1.6% |
0.0% |
BCBS KS/NE/W MO 00650/00655/00651 |
2.7% |
0.5% |
1.0% |
0.1% |
1.2% |
0.0% |
Noridian ND/CO/WY/IA/SD 00820/00824/00825/00826/00889 |
2.7% |
0.3% |
0.9% |
0.1% |
1.3% |
0.0% |
CIGNA ID 05130 |
2.3% |
0.1% |
0.7% |
0.2% |
1.4% |
0.0% |
Combined |
5.0% |
1.2% |
1.3% |
0.2% |
2.4% |
0.1% |