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