Claim Processing Accuracy definition

Claim Processing Accuracy means the accuracy rate achieved by HMO in processing claims in accordance with the provisions of a group’s medical benefit Coverage administered by HMO.
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Examples of Claim Processing Accuracy in a sentence

  • The penalty for Contractor's failure to meet the Claim Processing Accuracy shall be the amount shown in Attachment A.

  • Claims Payment -Financial Accuracy -Claim Processing Accuracy 99% of audited claim dollars paid accurately.

  • Claim Processing Accuracy is determined from an audit of randomly selected claims.

  • The Claim Processing Accuracy percentage is calculated dividing the number of accurately processed claims by the number of claims selected in the sample.

  • Claims Payment - Financial Accuracy - Claim Processing Accuracy 99% of audited claim dollars paid accurately.

  • Call/Inquiry -Average Speed of Answer (ASA) Claims Payment - Financial Accuracy - Claim Processing Accuracy Measured for the Term of the Agreement, results will not exceed: ●100% of calls within 30 seconds to answer a phone call ●80% of calls within 30 seconds to answer a phone call 99% of audited claim dollars paid accurately.

  • Claim Processing Accuracy refers to Claims without processing errors such as: 1.

  • County of Orange Human Resource Services/Employee Benefits Claims Payment -Financial Accuracy -Claim Processing Accuracy 99% of audited claim dollars paid accurately.

  • Account Level-HMO .0470.6% of actual annual premium Total Financial Commitment .423 2.0% of actual annual premium Client Name: County of Orange Account and/or SOC Number: Lead Claim Office: Agreement Term: Projected # of Enrolled Employee Lives: Sales Representative: Sales Office/Routing #: Underwriter Approval By: Claims Payment - Financial Accuracy - Claim Processing Accuracy 99% of audited claim dollars paid accurately.

  • PROPOSED PERFORMANCE COMMITMENTS AND PENALTIES – EARLY RETIREE PLANSMEDICAL/HMO BENEFITS PLAN Claims Payment - Financial Accuracy - Claim Processing Accuracy 99% of audited claim dollars paid accurately.