|
|
Denied Claims Accuracy Rates -- CY 2003
| Reg |
ST |
Samp Type |
Sample* |
Population |
Total Errors |
Improper Denial |
Improper Denial
(Adj.)# |
Overpayment |
Proper Denial+ |
| BOS |
CT |
MON |
134 |
13,522 |
18.75% |
16.98% |
8.81% |
1.77% |
0.00% |
| |
|
SEP |
121 |
14,210 |
7.69% |
6.02% |
2.59% |
0.49% |
1.18% |
| |
|
NS |
121 |
17,863 |
19.65% |
15.62% |
13.56% |
2.09% |
1.95% |
| |
| |
MA |
MON |
139 |
10,400 |
15.81% |
15.81% |
14.65% |
0.00% |
0.00% |
| |
|
SEP |
139 |
38,378 |
10.57% |
10.04% |
1.68% |
0.00% |
0.53% |
| |
|
NS |
139 |
36,889 |
16.08% |
8.70% |
7.50% |
7.39% |
0.00% |
| |
| |
ME |
MON |
148 |
3,847 |
30.04% |
16.36% |
10.87% |
0.00% |
13.68% |
| |
|
SEP |
150 |
3,726 |
3.95% |
3.90% |
0.93% |
0.00% |
0.04% |
| |
|
NS |
150 |
8,855 |
7.93% |
5.18% |
1.36% |
1.57% |
1.19% |
| |
| |
NH |
MON |
150 |
4,113 |
11.69% |
7.43% |
6.82% |
0.00% |
4.26% |
| |
|
SEP |
155 |
6,476 |
11.75% |
8.06% |
3.55% |
0.00% |
3.69% |
| |
|
NS |
154 |
17,313 |
27.51% |
17.60% |
15.21% |
7.57% |
3.46% |
| |
| |
NJ |
MON |
152 |
43,453 |
2.98% |
2.98% |
2.98% |
0.00% |
0.00% |
| |
|
SEP |
152 |
65,884 |
6.39% |
5.30% |
5.30% |
0.00% |
1.09% |
| |
|
NS |
152 |
28,843 |
13.07% |
12.64% |
11.37% |
0.43% |
0.00% |
| |
| |
NY |
MON |
151 |
102,234 |
33.63% |
33.63% |
14.31% |
0.00% |
0.00% |
| |
|
SEP |
151 |
102,934 |
9.88% |
7.68% |
5.40% |
0.00% |
2.20% |
| |
|
NS |
142 |
93,316 |
9.56% |
9.04% |
6.85% |
0.00% |
0.51% |
| |
| |
PR |
MON |
153 |
5,537 |
33.80% |
33.80% |
18.57% |
0.00% |
0.00% |
| |
|
SEP |
151 |
6,564 |
4.12% |
3.93% |
1.02% |
0.00% |
0.20% |
| |
|
NS |
152 |
20,937 |
17.52% |
14.13% |
11.40% |
2.90% |
0.49% |
| |
| |
RI |
MON |
152 |
3,776 |
6.92% |
5.44% |
3.32% |
0.00% |
1.48% |
| |
|
SEP |
151 |
7,597 |
1.98% |
1.98% |
0.51% |
0.00% |
0.00% |
| |
|
NS |
148 |
7,629 |
4.33% |
3.57% |
1.68% |
0.76% |
0.00% |
| |
| |
VT |
MON |
149 |
1,602 |
0.52% |
0.25% |
0.00% |
0.00% |
0.27% |
| |
|
SEP |
150 |
4,968 |
0.97% |
0.97% |
0.00% |
0.00% |
0.00% |
| |
|
NS |
149 |
3,103 |
7.09% |
4.33% |
3.64% |
2.76% |
0.00% |
| |
| PHL |
DC |
MON |
138 |
1,556 |
47.02% |
45.90% |
24.01% |
0.00% |
1.11% |
| |
|
SEP |
150 |
4,228 |
13.65% |
13.65% |
4.57% |
0.00% |
0.00% |
| |
|
NS |
150 |
2,474 |
4.63% |
4.10% |
2.92% |
0.00% |
0.54% |
| |
| |
DE |
MON |
134 |
570 |
43.07% |
43.07% |
15.45% |
0.00% |
0.00% |
| |
|
SEP |
136 |
5,690 |
7.81% |
6.54% |
5.69% |
0.00% |
1.27% |
| |
|
NS |
137 |
2,245 |
22.71% |
12.53% |
11.83% |
8.98% |
1.20% |
| |
| |
MD |
MON |
148 |
15,799 |
15.09% |
13.75% |
11.83% |
0.00% |
1.34% |
| |
|
SEP |
150 |
52,164 |
11.87% |
9.11% |
8.07% |
0.00% |
2.76% |
| |
|
NS |
150 |
40,301 |
6.55% |
5.64% |
4.43% |
0.91% |
0.00% |
| |
| |
PA |
MON |
153 |
62,970 |
22.75% |
21.37% |
10.87% |
0.00% |
1.38% |
| |
|
SEP |
155 |
71,789 |
16.96% |
12.68% |
12.16% |
0.00% |
4.28% |
| |
|
NS |
153 |
34,554 |
30.99% |
25.35% |
21.60% |
0.00% |
5.64% |
| |
| |
VA |
MON |
155 |
27,307 |
13.64% |
13.00% |
10.72% |
0.00% |
0.64% |
| |
|
SEP |
155 |
33,279 |
13.28% |
10.01% |
8.82% |
0.00% |
3.27% |
| |
|
NS |
153 |
27,916 |
9.79% |
6.65% |
5.81% |
0.00% |
3.14% |
| |
| |
WV |
MON |
149 |
2,549 |
21.30% |
21.30% |
9.80% |
0.00% |
0.00% |
| |
|
SEP |
150 |
10,746 |
10.63% |
7.14% |
5.73% |
0.00% |
3.49% |
| |
|
NS |
150 |
7,985 |
13.94% |
4.95% |
3.89% |
2.39% |
6.60% |
| |
| ATL |
AL |
MON |
169 |
34,222 |
10.73% |
10.73% |
8.07% |
0.00% |
0.00% |
| |
|
SEP |
152 |
25,168 |
4.82% |
2.51% |
2.08% |
0.00% |
2.31% |
| |
|
NS |
176 |
31,797 |
13.86% |
6.35% |
4.10% |
1.80% |
5.71% |
| |
| |
FL |
MON |
155 |
38,203 |
5.46% |
4.16% |
1.37% |
0.00% |
1.30% |
| |
|
SEP |
156 |
91,430 |
5.54% |
3.72% |
0.59% |
0.00% |
1.81% |
| |
|
NS |
156 |
36,891 |
6.46% |
4.24% |
3.31% |
1.20% |
1.01% |
| |
| |
GA |
MON |
151 |
30,657 |
20.09% |
16.96% |
10.51% |
0.00% |
3.12% |
| |
|
SEP |
152 |
72,187 |
4.70% |
1.86% |
1.86% |
0.77% |
2.07% |
| |
|
NS |
152 |
32,793 |
7.91% |
3.60% |
2.93% |
0.85% |
3.46% |
| |
| |
KY |
MON |
126 |
7,589 |
4.54% |
4.54% |
4.15% |
0.00% |
0.00% |
| |
|
SEP |
154 |
29,571 |
14.55% |
12.45% |
11.49% |
1.33% |
0.77% |
| |
|
NS |
155 |
13,493 |
18.71% |
13.37% |
12.86% |
2.25% |
3.09% |
| |
| |
MS |
MON |
155 |
13,073 |
4.30% |
4.30% |
2.72% |
0.00% |
0.00% |
| |
|
SEP |
155 |
30,422 |
3.78% |
3.78% |
1.35% |
0.00% |
0.00% |
| |
|
NS |
155 |
12,556 |
0.60% |
0.60% |
0.00% |
0.00% |
0.00% |
| |
| |
NC |
MON |
153 |
37,670 |
12.60% |
10.12% |
6.25% |
0.00% |
2.48% |
| |
|
SEP |
150 |
62,646 |
8.47% |
5.91% |
5.22% |
0.00% |
2.56% |
| |
|
NS |
139 |
56,099 |
16.67% |
13.90% |
12.27% |
0.00% |
2.77% |
| |
| |
SC |
MON |
150 |
1,974 |
10.02% |
9.49% |
6.86% |
0.00% |
0.52% |
| |
|
SEP |
156 |
47,260 |
12.88% |
9.89% |
5.71% |
2.99% |
0.00% |
| |
|
NS |
156 |
14,373 |
32.21% |
11.56% |
9.81% |
19.34% |
1.96% |
| |
| |
TN |
MON |
146 |
16,030 |
22.47% |
18.00% |
9.07% |
0.00% |
4.47% |
| |
|
SEP |
150 |
35,987 |
11.22% |
7.04% |
1.94% |
0.75% |
3.43% |
| |
|
NS |
150 |
5,600 |
15.43% |
13.76% |
7.79% |
0.00% |
1.67% |
| |
| DAL |
AR |
MON |
134 |
6,855 |
19.79% |
19.79% |
12.97% |
0.00% |
0.00% |
| |
|
SEP |
147 |
29,242 |
8.61% |
8.61% |
8.00% |
0.00% |
0.00% |
| |
|
NS |
146 |
18,580 |
17.74% |
16.24% |
14.94% |
2.15% |
0.00% |
| |
| |
CO |
MON |
122 |
2,852 |
38.60% |
38.60% |
11.78% |
0.83% |
0.00% |
| |
|
SEP |
149 |
81,898 |
12.54% |
7.06% |
5.62% |
0.66% |
4.81% |
| |
|
NS |
149 |
136,108 |
14.59% |
7.60% |
4.33% |
1.08% |
5.91% |
| |
| |
LA |
MON |
146 |
6,005 |
36.55% |
27.50% |
20.06% |
0.30% |
9.04% |
| |
|
SEP |
156 |
29,865 |
9.55% |
6.77% |
4.30% |
0.00% |
2.78% |
| |
|
NS |
156 |
31,276 |
17.43% |
9.53% |
8.90% |
3.76% |
4.14% |
| |
| |
MT |
MON |
144 |
1,862 |
17.95% |
16.03% |
13.51% |
0.00% |
1.92% |
| |
|
SEP |
150 |
7,402 |
6.83% |
5.54% |
3.06% |
0.00% |
1.30% |
| |
|
NS |
150 |
5,515 |
18.25% |
16.31% |
11.12% |
0.00% |
1.94% |
| |
| |
ND |
MON |
151 |
1,864 |
0.00% |
0.00% |
0.00% |
0.00% |
0.00% |
| |
|
SEP |
152 |
3,309 |
6.81% |
6.81% |
0.85% |
0.00% |
0.00% |
| |
|
NS |
145 |
4,552 |
8.58% |
7.85% |
6.89% |
0.00% |
0.72% |
| |
| |
NM |
MON |
146 |
9,495 |
12.88% |
9.76% |
4.80% |
1.06% |
2.07% |
| |
|
SEP |
158 |
4,992 |
2.50% |
1.19% |
1.19% |
0.00% |
1.31% |
| |
|
NS |
156 |
831 |
2.02% |
1.41% |
0.93% |
0.60% |
0.00% |
| |
| |
OK |
MON |
149 |
17,514 |
3.56% |
3.01% |
0.00% |
0.00% |
0.55% |
| |
|
SEP |
156 |
24,581 |
5.94% |
5.23% |
2.10% |
0.00% |
0.71% |
| |
|
NS |
156 |
19,901 |
8.57% |
4.35% |
3.09% |
0.00% |
4.22% |
| |
| |
SD |
MON |
150 |
2,809 |
10.82% |
10.82% |
3.61% |
0.00% |
0.00% |
| |
|
SEP |
149 |
3,997 |
4.77% |
2.15% |
2.15% |
2.09% |
0.53% |
| |
|
NS |
150 |
7,008 |
9.81% |
3.80% |
3.16% |
5.08% |
0.93% |
| |
| |
TX |
MON |
151 |
97,643 |
6.61% |
6.61% |
6.04% |
0.00% |
0.00% |
| |
|
SEP |
150 |
188,308 |
20.77% |
18.84% |
17.25% |
0.00% |
1.93% |
| |
|
NS |
151 |
227,267 |
14.25% |
12.07% |
12.07% |
1.57% |
0.62% |
| |
| |
UT |
MON |
137 |
3,728 |
26.75% |
26.75% |
21.46% |
0.00% |
0.00% |
| |
|
SEP |
152 |
17,042 |
7.64% |
6.25% |
5.20% |
0.00% |
1.39% |
| |
|
NS |
152 |
28,963 |
17.09% |
5.65% |
3.90% |
0.55% |
10.89% |
| |
| |
WY |
MON |
140 |
1,848 |
25.28% |
24.35% |
17.11% |
0.00% |
0.93% |
| |
|
SEP |
146 |
2,976 |
6.89% |
5.14% |
3.04% |
0.00% |
1.76% |
| |
|
NS |
146 |
5,087 |
13.84% |
12.46% |
9.66% |
0.00% |
1.38% |
| |
| CHI |
IA |
MON |
150 |
6,293 |
14.52% |
12.99% |
7.27% |
0.00% |
1.53% |
| |
|
SEP |
153 |
24,169 |
15.24% |
10.91% |
7.40% |
1.66% |
2.66% |
| |
|
NS |
153 |
13,514 |
26.83% |
22.71% |
21.02% |
1.96% |
2.16% |
| |
| |
IL |
MON |
147 |
46,766 |
13.57% |
12.78% |
10.02% |
0.00% |
0.79% |
| |
|
SEP |
150 |
84,560 |
13.91% |
11.38% |
10.04% |
0.00% |
2.53% |
| |
|
NS |
150 |
91,906 |
24.34% |
15.20% |
12.20% |
3.10% |
6.05% |
| |
| |
IN |
MON |
149 |
33,025 |
7.06% |
7.06% |
7.06% |
0.00% |
0.00% |
| |
|
SEP |
150 |
41,926 |
3.21% |
3.21% |
3.21% |
0.00% |
0.00% |
| |
|
NS |
150 |
37,596 |
5.94% |
5.05% |
4.53% |
0.37% |
0.53% |
| |
| |
KS |
MON |
150 |
19,227 |
2.34% |
2.34% |
2.34% |
0.00% |
0.00% |
| |
|
SEP |
153 |
21,829 |
0.69% |
0.00% |
0.00% |
0.00% |
0.69% |
| |
|
NS |
153 |
22,959 |
1.15% |
0.76% |
0.00% |
0.40% |
0.00% |
| |
| |
MN |
MON |
142 |
13,106 |
30.58% |
30.58% |
16.38% |
0.00% |
0.00% |
| |
|
SEP |
148 |
28,585 |
21.84% |
16.17% |
4.88% |
0.56% |
5.12% |
| |
|
NS |
150 |
42,963 |
30.10% |
13.86% |
8.34% |
11.04% |
5.20% |
| |
| |
MO |
MON |
150 |
39,232 |
11.40% |
11.38% |
7.45% |
0.00% |
0.02% |
| |
|
SEP |
150 |
59,728 |
4.98% |
4.24% |
3.83% |
0.00% |
0.73% |
| |
|
NS |
146 |
105,550 |
34.24% |
32.94% |
17.20% |
0.66% |
0.64% |
| |
| |
NE |
MON |
150 |
4,386 |
8.59% |
7.40% |
6.40% |
0.00% |
1.19% |
| |
|
SEP |
150 |
62,078 |
9.48% |
3.15% |
3.15% |
1.57% |
4.76% |
| |
|
NS |
147 |
23,253 |
17.65% |
13.90% |
11.98% |
1.37% |
2.39% |
| |
| |
OH |
MON |
155 |
56,543 |
20.50% |
15.29% |
13.52% |
0.00% |
5.20% |
| |
|
SEP |
155 |
58,161 |
12.71% |
6.94% |
6.22% |
0.00% |
5.76% |
| |
|
NS |
154 |
40,725 |
19.26% |
15.42% |
14.12% |
0.00% |
3.83% |
| |
| |
WI |
MON |
156 |
39,474 |
6.27% |
5.69% |
4.65% |
0.00% |
0.58% |
| |
|
SEP |
156 |
50,944 |
12.64% |
9.49% |
5.05% |
1.98% |
1.18% |
| |
|
NS |
156 |
67,227 |
29.04% |
24.67% |
17.72% |
4.37% |
0.00% |
| |
| SF |
AK |
MON |
146 |
5,182 |
6.97% |
4.61% |
2.92% |
0.91% |
1.45% |
| |
|
SEP |
147 |
12,001 |
23.69% |
10.16% |
7.82% |
1.37% |
12.16% |
| |
|
NS |
145 |
16,854 |
9.63% |
5.05% |
3.67% |
1.65% |
2.94% |
| |
| |
AZ |
MON |
150 |
17,553 |
13.78% |
13.03% |
6.49% |
0.00% |
0.74% |
| |
|
SEP |
156 |
33,196 |
21.72% |
10.89% |
7.26% |
0.00% |
10.82% |
| |
|
NS |
156 |
39,658 |
22.83% |
12.64% |
9.28% |
2.71% |
8.16% |
| |
| |
CA |
MON |
150 |
293,404 |
3.39% |
3.39% |
1.67% |
0.00% |
0.00% |
| |
|
SEP |
153 |
354,796 |
6.58% |
5.97% |
4.62% |
0.00% |
0.60% |
| |
|
NS |
152 |
486,766 |
9.89% |
9.22% |
8.25% |
0.67% |
0.00% |
| |
| |
HI |
MON |
149 |
626 |
3.94% |
3.14% |
2.40% |
0.00% |
0.80% |
| |
|
SEP |
149 |
7,991 |
12.44% |
3.04% |
3.04% |
2.17% |
7.23% |
| |
|
NS |
149 |
18,324 |
18.23% |
6.08% |
6.08% |
1.64% |
10.51% |
| |
| |
ID |
MON |
148 |
1,612 |
7.61% |
6.82% |
5.83% |
0.79% |
0.00% |
| |
|
SEP |
158 |
7,595 |
6.28% |
5.02% |
2.74% |
0.00% |
1.26% |
| |
|
NS |
163 |
13,014 |
16.85% |
11.54% |
10.97% |
0.00% |
5.31% |
| |
| |
NV |
MON |
139 |
3,068 |
23.32% |
22.65% |
9.60% |
0.00% |
0.67% |
| |
|
SEP |
149 |
25,987 |
10.38% |
9.06% |
6.02% |
0.00% |
1.33% |
| |
|
NS |
149 |
20,991 |
11.18% |
9.60% |
4.91% |
1.57% |
0.00% |
| |
| |
OR |
MON |
98 |
11,803 |
8.86% |
8.86% |
6.96% |
0.00% |
0.00% |
| |
|
SEP |
101 |
30,622 |
13.44% |
8.87% |
6.77% |
0.00% |
4.57% |
| |
|
NS |
101 |
25,049 |
15.65% |
12.90% |
8.09% |
2.75% |
0.00% |
| |
| |
WA |
MON |
183 |
7,713 |
2.76% |
2.76% |
1.16% |
0.00% |
0.00% |
| |
|
SEP |
185 |
49,164 |
12.96% |
8.35% |
7.21% |
.54% |
4.07% |
| |
|
NS |
179 |
74,256 |
11.92% |
11.28% |
10.36% |
1.74% |
.00% |
| |
|
|
|
|
|
|
|
|
|
| |
US |
MON |
7,492 |
1,230,141 |
12.18% |
11.34% |
6.87% |
.04% |
.81% |
| |
|
SEP |
7,669 |
2,170,249 |
10.56% |
8.01% |
6.16% |
.30% |
2.25% |
| |
|
NS |
7,649 |
2,179,517 |
15.39% |
11.78% |
9.34% |
1.70% |
1.98% |
Note: U. S. totals exclude Michigan, which did not complete a sufficient
number of sample cases to produce statistically reliable estimates.
* Excludes cases not meeting DCA definition for inclusion in population,
withdrawn claims, and claims for which monetary eligibility was
established upon receipt of CWC, UCFE, and/or UCX wage credits.
# Adjusted rate excludes erroneous denials that were corrected by agency
and claims for which eligibility was established through appeal prior
to DCA case completion.
+ Properly denied, but for wrong reason or section of the law.
Prepared by OWS Division of Performance Management on 19 May 04
|
