Standard Threshold Total Annual Liquidated Damages 90% of all claims 90.00% - 100.00% None processed in 30 85.00% - 89.99% 2.0% of TPA Fees calendar days 85.00% 4.0% of TPA Fees Claim Financial Accuracy Mathematically, the financial accuracy of a universe of claims is the dollars paid correctly divided by the total dollars paid, stated as a percentage. Standard Threshold Total Annual Liquidated Damages 99.00% Accuracy 99.00% - 100.00% None 98.00% - 98.99% 2.0% of TPA Fees 97.00% - 97.99% 3.0% of TPA Fees 97.00% 4.0% of TPA Fees Claim Payment Accuracy The Payment Accuracy of a universe of claims is the number of claims paid correctly divided by the total number of claims, stated as a percentage. Payment accuracy reflects the percentage of claims that are paid correctly. Standard Threshold Annual Liquidated Damages 97% Accuracy 97.00% - 100.00% None 95.00% - 96.99% 2.0% of TPA Fees 95.00% 3.0% of TPA Fees Processing Accuracy The Processing Accuracy of a universe of claims is the number of claims processed correctly divided by the number of claims. Claims with payment errors will not be considered in the calculation of processing accuracy. Standard Threshold Annual Liquidated Damages 95% Accuracy 95.00% - 100.00% None 93.50% - 94.99% 2.0% of TPA Fees Below 93.50% 3.0% of TPA Fees
Standard 90% of all claims processed in 30 calendar days Threshold 90.00% - 100.00% 85.00% - 89.99% 85.00% Total Annual Liquidated Damages None 2.0% of TPA Fees 4.0% of TPA Fees Claim Financial Accuracy Mathematically, the financial accuracy of a universe of claims is the dollars paid correctly divided by the total dollars paid, stated as a percentage. Standard 99.00% Accuracy Threshold 99.00% - 100.00% 98.00% - 98.99% 97.00% - 97.99% 97.00% Total Annual Liquidated Damages None 2.0% of TPA Fees 3.0% of TPA Fees 4.0% of TPA Fees Claim Payment Accuracy The Payment Accuracy of a universe of claims is the number of claims paid correctly divided by the total number of claims, stated as a percentage. Payment accuracy reflects the percentage of claims that are paid correctly. Standard 97% Accuracy Threshold 97.00% - 100.00% 95.00% - 96.99% 95.00% Annual Liquidated Damages None 2.0% of TPA Fees 3.0% of TPA Fees Processing Accuracy The Processing Accuracy of a universe of claims is the number of claims processed correctly divided by the number of claims. Claims with payment errors will not be considered in the calculation of processing accuracy. Standard 95% Accuracy Threshold 95.00% - 100.00% 93.50% - 94.99% Below 93.50% Annual Liquidated Damages None 2.0% of TPA Fees 3.0% of TPA Fees
third-party-administrator-rfp-final.docx