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SFGTV August 17, 2014

Accuracy. And again, things shading where uhc did much better with over all accuracy, from improving doing better than eight of the past, since the audits that we have completed. The payment accuracy, and this is one, where uhc barely missed our standard at 9748 uhc, our standard is 9950. So, because of the frequency, of errors, just barely missed or satisfaction level. And here is where we get into the over payment and the under payments for the errors. And for insample we have a total of 12 er...
Rebecca Ryan Much Better Additional Information Insurance Information Sno Way Million Dollar

SFGTV August 18, 2014

Provide us with information to determine what is the over all impact. And are the over payments or under payments . And so that is just. Why dont you apply it . We dont believe in extrapolating out to say, because we had a 5 error here that means that it is 5 Million Dollar error in the universe. Why not . So it is just our they have done an analysis and determined that is not the process that we utilize and but we do work one on one. We do work one on one with the administrators to determine, t...
Rebecca Ryan Million Dollar Additional Information Customer Service Service Members Level Service

SFGTV August 14, 2014

Of the dollar amount, right, exactly. And payment is just that an error was made. And any kind of payment error in the sample and so anything that is origin, it could be of any dollar size, and counts as an error. And over all, it is all kinds of errors, financial or payment or nonpayment error and we are looking at over Member Experience and you can have a situation where the claim is miskeyed for a date of service. And that particular claim may pay the right amount, but it could lead to a fina...
Member Experience Little Things High Frequency Big Dollar High Volume Therapy Office

SFGTV August 15, 2014

If everyone is up by 5 and it happens 55,000 times and we dont audit that because it is too small and we dont appreciate the frequency that leads to a big dollar amount. So, it is we randomly select within the each strata, bucket but we see a lot of the most frequent claims because there is a high volume. If you look at the high volume of claims and normally see the physical therapy and the office claims in the universe, those are going to end up in the sample. Through that random process. So yo...
Big Dollar High Volume Therapy Office Much Better Additional Information Insurance Information

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UNICEF is the worldโ€™s farthest-reaching humanitarian organization for children. Across 190 countries and territories, and in the worldโ€™s toughest places, we work day in and day out to help children survive. To defend their rights. To keep them protected, healthy and educated. To give them a fair chance to fulfil their potential. Our work for every child relies entirely on voluntary support, including donations from generous Canadians.
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