submitted to EBD -Date EBD cashed check -Payment Reason -Payment sent to EBD PO Box (Yes/No) -Payment submitted on time (Yes/No). If no, must explain in comments section and submit any supporting documentation at the time the report is due. Claims Standards: 99% of claim dollars Measured by the 97%-98.99% Financial Accuracy processed accurately State's independent accuracy: 1% of The ratio of auditor as part of annual reimbursements the annual claims administrative fees; paid accurately to all audit. Criteria as Less than 97%: 2% of reimbursements. defined by the annual This is determined State's independent administrative fees by calculating the auditor. Measured extrapolated to two (2) decimal weighted average places. dollar error in the sample and applying this to the population of processed claims, whether all substantiation requirements are met is considered. Claims Standards: 97% of claims w/ Measured by the Less than 97%: 2% of Payment Accuracy benefit payments State's independent annual The ratio of the total are processed auditor as part of administrative fees number of accurately the annual claims reimbursements audit. Criteria as without either defined by the payment or State's independent processing errors to auditor. Measured all reimbursements to two (2) decimal processed during the places. audit time period. This is determined by calculating the
submitted to EBD -Date EBD cashed check -Payment Reason -Payment sent to EBD PO Box (Yes/No) -Payment submitted on time (Yes/No). If no, must explain in comments section and submit any supporting documentation at the time the report is due. Claims Standards: Financial Accuracy The ratio of reimbursements paid accurately to all reimbursements. This is determined by calculating the extrapolated weighted average dollar error in the sample and applying this to the population of processed claims, whether all substantiation requirements are met is considered. 99% of claim dollars processed accurately Measured by the State's independent auditor as part of the annual claims audit. Criteria as defined by the State's independent auditor. Measured to two (2) decimal places. 97%-98.99% accuracy: 1% of annual administrative fees; Less than 97%: 2% of annual administrative fees Claims Standards: Payment Accuracy The ratio of the total number of reimbursements without either payment or processing errors to all reimbursements processed during the audit time period. This is determined by calculating the 97% of claims w/ benefit payments are processed accurately Measured by the State's independent auditor as part of the annual claims audit. Criteria as defined by the State's independent auditor. Measured to two (2) decimal places. Less than 97%: 2% of annual administrative fees
FSATechPropAttachQ.docx