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November 19, 2004:
Reconciliation of Third-Party Claims
| |
| STATISTIC |
PHARMACY1 |
PHARMACY2 |
PHARMACY3 |
PHARMACY4 |
PHARMACY5 |
PHARMACY6 |
PHARMACY7 |
OVERALL |
| TOTAL CLAIMS |
3106 |
1195 |
4195 |
4109 |
2147 |
2221 |
4093 |
21068 |
| DIFFERENCE (%) |
29
(0.93%)
|
9
(0.75%)
|
11
(0.26%)
|
11
(0.27%)
|
128
(5.96%)
|
16
(0.72%)
|
2
(0.05%)
|
206
(0.98%) |
| SUMOF DIFERENCE |
$475.78 |
$44.26 |
$441.27 |
$778.97 |
$2372.21 |
$133.20 |
$13.94 |
$4259.63 |
AVERAGE
DIFFERENCES
(SD)
|
$16.41
($16.93)
|
$4.92
($20.85)
|
$40.12
($67.76)
|
$70.82
($142.69)
|
$18.53
($30.17)
|
$8.33
($8.15)
|
$6.97
($18.38)
|
$20.68
($45.04)
|
RANGE
DIFFERENCE
|
$0.21 TO
$67.25
|
(-$47.63) TO
$23.11
|
$0.82 TO
$224.67
|
$0.25 TO
$359.30
|
(- $53.99) TO
$170.35
|
$1.14 TO
$31.12
|
(-$6.03)TO
$19.97
|
(-553.99)
TO $359.35 |
AVERAGE
REIMBURSEMENT
TIME
(IN DAYS)
|
48.5 |
36.1 |
26.6 |
38.4 |
42.7 |
33.7 |
5.5 |
41.1 |
|
| |
| TABLE 2. THIRD-PARTY
RANKINGS |
| PAYOR |
TOTAL
RECONCILED
|
TOTAL
DIFFERENCES
|
PERCENT
DIFFERENCES
|
PERCENT
RANK
|
AVERAGE DAYS TO PAYMENT |
DAYS RANK |
AVERAGE
DIFFERENCE
AMOUNT
|
AMOUNT
RANK
|
| A |
4632 |
3 |
0.0006 |
3 |
34 |
4 |
$10.63 |
2 |
| B |
552 |
4 |
0.0072 |
6 |
34 |
4 |
$12.19 |
3 |
| C |
637 |
0 |
0.0000 |
1 |
. |
. |
.. |
|
| D |
223 |
0 |
0.0000 |
1 |
. |
. |
.. |
|
| E |
205 |
2 |
0.0098 |
8 |
22 |
1 |
$39.66 |
9 |
| F |
240 |
14 |
0.0583 |
11 |
77 |
9 |
$14.16 |
4 |
| G |
3768 |
13 |
0.0035 |
5 |
33 |
2 |
$2.47 |
1 |
| H |
6635 |
61 |
0.0092 |
7 |
37 |
7 |
$25.09 |
7 |
| I |
1803 |
58 |
0.0322 |
9 |
34 |
3 |
$19.04 |
5 |
| J |
268 |
10 |
0.0373 |
10 |
44 |
8 |
$19.94 |
6 |
| K |
614 |
2 |
0.0033 |
4 |
35 |
6 |
$29.81 |
8 |
|
*NOTE: Days to payment were
only collected for claims when difference existed.
**
NOTE: Since no differences were noted, this difference
amount cannot be estimated.
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