The economics
11.7949% of remittance lines came in under the contracted amount — the comparison that only exists once the 835 feed and the agreement are both loaded.
Contracted against paid, line by line
11.79%Synthetic — demonstration onlyof 390 remittance lines came in under the contracted amount
-3.87%Synthetic — demonstration onlynet variance against contracted, across the whole sample
The payer mix behind it
- Blue Cross and Blue Shield of Texas25.8379%
- Medicare FFS23.2214%
- Texas Medicaid (STAR)15.632%
- Medicare Advantage15.4213%
- Self-pay and other1.898%
- Aetna7.5604%
- UnitedHealthcare6.8537%
- Cigna Healthcare3.5752%