WCMBP_Section_J_Attachment_18.4_-_Dec_2013_Monthly_RTP_Reports_by_Reasons_and_by_Program_AMD_5.xlsx

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Solicitation Notice for Workers' Compensation Medical Bill Processing (WCMBP)
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DOL141RP21903
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WCMBP_Section_J_Attachment_18.4_-_Dec_2013_Monthly_Report

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RTP Reasons

RTP Report December 2013RTP CodeFECADCMWCDEEOIC
Claimant Pay Medical
SSN missing/invalid or SSN/name mismatch.11
FECA: Claimant signature & date missing.387
FECA: Amount paid by claimant missing.7103
FECA: Date of service/purchase missing.827
Other244
FECA: NDC missing.25
FECA: Drug quantity missing.26
Charges missing/invalid32
FECA: Claimant signature & date missing.35
Black Lung: Date of service/purchase missing.51
Black Lung: Receipts/proof of payment missing53
Claimant Pay Pharmacy
FECA & Black Lung: SSN missing/invalid or SSN/name mismatch.1
FECA: Claimant signature & date missing.35
FECA: Amount paid by claimant missing.72
FECA: Date of service/purchase missing.8
No Receipts Attached17
FECA: NDC missing.25150
FECA: Drug quantity missing.26104
Charges missing/invalid32
Prescription number missing33
Date of dispense missing34
No signature on bill35
Black Lung: NDC Missing491
Black Lung: Amount paid by claimant missing50
Black Lung: Date of service/purchase missing.51
Black Lung: Claimant signature & date missing52
Black Lung: Receipts/proof of payment missing53
Black Lung: Prescription number missing54
Black Lung: Drug quantity missing551
Dental
FECA: SSN missing/invalid or SSN/name mismatch.1
FECA: Procedure codes missing or invalid.5
FECA: Line item charges missing or invalid.7
FECA: Date of service missing/invalid/future.8
No Tax ID Number9
FECA: Provider Identification Number is missing/invalid1138
FECA: Physician signature is missing.127
Charges missing/invalid32
No signature on bill35
Submitted tax ID does not match provider number5923
HCFA
SSN missing/invalid or SSN/name mismatch (Block 11)12420238246
Provider Number Missing: 33 of HCFA or 51 of UB2
Signature or approved wording missing (Block 12 or Block 13)372010346
Diagnosis codes are missing or all codes present are invalid (Block 21)44741625
Procedure codes missing/invalid (Block 24d)521031318
Place of Service Missing66622519
Detail line charges are missing (Block 24f)7221880
Date of service is missing/invalid/future (Block 24a)83122262
No Tax ID Number9
Energy: Facility zip code is missing (Block 32)
FECA: Missing facility name/address (Block 32)102894
No active provider number on file or provider number missing in box 33 of a HCFA or box 51 of a UB11150726881788
Physicians signature is missing (Block 31)12137634211
Charges missing/invalid32
No signature on bill35
Black Lung & Energy: Diagnosis code pointer is blank & more than 1 diagnosis code is present (Block 24e)363632
Submitted tax ID does not match provider number59167134128
No active prov # on file88
OWCP957
SSN missing/invalid or SSN/name mismatch1311
FECA: Claimant signature missing.3239
FECA: Travel expense missing.71023
FECA: Date of travel is missing.8
Submit on OWCP-957 (incorrect form)232211
FECA: Travel from/to missing.241
Charges missing/invalid32
No signature on bill35
Black Lung: Date of travel is missing.391167
Black Lung: One way/round trip missing.402
Black Lung: Travel from/to missing.412
No provider42
Black Lung: Mileage missing.43
Black Lung: Claimant signature missing.448
Black Lung: Travel expense missing.454
Black Lung: Physician signature missing.464
Diagnosis code missing47
Black Lung: Date care rendered missing.486
Pharmacy
SSN missing/invalid or SSN/name mismatch127
FECA: Detail line charges missing.725
FECA: Date of service missing/invalid/future.872
No Tax ID Number9
FECA: NCPDP missing/invalid.11129
Authorized pharmacy representative signature missing.127
NDC missing25461
Quantity missing261071
Charges missing/invalid32
Black Lung & Energy: Prescription number missing3321
Black Lung & Energy: Date of service missing/invalid/future.341
Energy: Patient signature missing.3532
Black Lung & Energy: Detail line charges missing.371
Black Lung & Energy: NCPDP missing/invalid.382
NDC missing49
Amount paid by claimant50
Date of service/purchase missing51
Claimant signature & date missing52
Receipts/proof of payment missing53
Prescription number missing54
Drug quantity missing55
Black Lung: Patient signature missing.56
UB
SSN missing/invalid or SSN/name mismatch (Block 60)13524668
Provider Number Missing: 33 of HCFA or 51 of UB2
FECA: Principal diagnosis code is missing/invalid (Block 67)4111
FECA: Detail line charges missing (Block 47)7231
No Tax ID Number9
No active provider number on file or provider number missing in box 33 of a HCFA or box 51 of a UB112396117592
Physicians signature is missing (Block 85)126
Type of bill missing (Block 4)2798314
Black Lung & Energy: Statement covers period is missing/invalid/future (Block 6)284
Revenue code is missing/invalid (Block 42)296965
Energy: Principal diagnosis code is missing/invalid (Block 67)
Black Lung: Principal diagnosis code is missing/invalid(Block 67) or diagnoses are handwritten3075
Black Lung & Energy: Admission date is missing/invalid/future (Block 17)314
Black Lung & Energy: Detail line charges missing (Block 47)32320
No signature on bill35
FECA & Energy: Provider type 01 & Medicare # missing on UB type 1115720744
Incorrect Form5887
No active prov # on file88

Bill minus Pharmacy

DCMWC
12/2013Gross Bill VolumeRejRTPNet Bill VolumeDEEOIC
12/2013Gross Bill VolumeRejRTPNet Bill VolumeFECA
12/2013Gross Bill VolumeRejRTPNet Bill VolumeAll
12/2013Gross Bill VolumeRejRTPNet Bill Volume
CM67390664CP2741080166BH5619083645249655BH5619083645249655
CP2011CR514195490CM0CM67390664
CR4004HC2006756241817593CP73566166503CP1011174167670
HC622349905229HP28130278CR2146742131859CR2664932182353
HP84640842OW325027103213DN253709093DN253709093
OW4591624419RX6703631HC15934821616604142528HC18563827620012165350
RX6024UB3003HP0HP1127701120
U411029UN1891283681495HR42581104247HR42581104247
UN6881298578UW1522123621148NU2101NU2101
UW276354219Bills27869253319924417OW29049286281025953OW32758329284429585
Bills91884811717969RX34110836197RE24970242RE24970242
RX8035Bills w/o RX27528145316324220RX42052112743720RX42782113123755
Bills w/o RX91804811687964U46033U4170512
UB200128UB2301211
UN86962617106960UN112756621769033
UR62410623UR62410623
UW89942216227350UW107923720388717
Bills274775107429956243745Bills311832137534326276131
RX49402774404223RX52893854794425
Bills w/o RX26983579729516239522Bills w/o RX30654399033847271706
DCMWC
12/2013Gross Bill VolumeRejRTPNet Bill VolumeDEEOIC
12/2013Gross Bill VolumeRejRTPNet Bill VolumeFECA
12/2013Gross Bill VolumeRejRTPNet Bill Volume
CA-978 (CM)67390664CA-915 Pharmacy (CP)2741080166CA-915 Pharmacy (CP)73566166503
CA-915 Pharmacy (CP)2011CA-915 Medical (CR)514195490CA-915 Medical (CR)2146742131859
CA-915 Medical (CR)4004HCFA2034859241817871Dental (DN)253709093
HCFA706989906071OWCP 957 (OW)325027103213Carrier Reimbursement48821204870
OWCP 957 (OW)4591624419Pharmacy (RX)6703631HCFA21553829923056192183
Pharmacy (RX)6024UB3416407302646Nurse (NU)2101
UB97515154806Bills27869253319924417OWCP 957 (OW)29049286281025953
Bills91884811717969RX34110836197Rehab (RE)24970242
RX8035Bills w/o RX27528145316324220Pharmacy (RX)42052112743720
Bills w/o RX91804811687964UB1771648334714321
Bills274775107429956243745
RX49402774404223
Bills w/o RX26983579729516239522

FECA RTP Volume

FECA HCFAFECA UB
DateTotal Bills Received

Lbryant: Lbryant:

Total number of bills received - does not include prompt pay. Total Bills RTP'd Lbryant: Lbryant:

Total number of bills that RTP'd for any reason % Bills RTP'd Lbryant: Lbryant:

% of total bills received that RTP'd for any reason RTP'd Prov # Combined Lbryant: Lbryant:

Total number of bills that RTP'd for missing provider # or prov # & more than 1 reason RTP'd Missing Prov # & Other Reason Lbryant: Lbryant:

Bills RTP'd for missing provider in addition to other RTP reasons RTP'd Missing Prov # Only Lbryant: Lbryant:

Bills RTP'd only for missing provider number in block 33 % Total Bill Received RTP Prov # Lbryant: Lbryant:

% of total bills received that RTP'd for missing provider number. % of RTP Prov # Lbryant: Lbryant:

% of total bills RTP'd for any reason that RTP'd for missing provider number. Date Total Bills Received Total Bills RTP'd % Bills RTP'd RTP'd Prov # Combined RTP'd Missing Prov # & Other Reason RTP'd Missing Prov # Only Lbryant: Lbryant:

Bills RTP'd only for missing provider number in block 33 Lbryant: Lbryant:

Total number of bills received - does not include prompt pay.

Lbryant: Lbryant:

Total number of bills that RTP'd for any reason Lbryant: Lbryant:

% of total bills received that RTP'd for any reason Lbryant: Lbryant:

Total number of bills that RTP'd for missing provider # or prov # & more than 1 reason Lbryant: Lbryant:

Bills RTP'd for missing provider in addition to other RTP reasons Lbryant: Lbryant:

Bills RTP'd only for missing provider number in block 33 Lbryant: Lbryant:

% of total bills received that RTP'd for missing provider number.

Lbryant: Lbryant:

% of total bills RTP'd for any reason that RTP'd for missing provider number.% Total Bill Received RTP Prov #% of RTP Prov #RTP Medicare #% Total Bill Received RTP Medicare #% of RTP Medicare #
12/02/133139030789.81%225422220327.18%73.23%12/02/13270851318.94%3651734813.48%71.15%321.18%6.24%
12/03/13437954512.45%364393258.31%66.79%12/03/134016215.46%4944512.22%79.03%51.25%8.06%
12/04/13270937213.73%270262449.97%72.58%12/04/132564617.97%3132812.11%67.39%0.00%0.00%
12/05/1363176319.99%442234197.00%70.05%12/05/1350513025.74%10579820.79%80.77%40.79%3.08%
12/06/13724686111.88%592465468.17%68.76%12/06/1352210419.92%7637314.56%73.08%30.57%2.88%
12/09/1319248211610.99%153515613797.97%72.54%12/09/13139728520.40%217920815.53%76.14%231.65%8.07%
12/10/1311922166313.95%1497312118512.56%90.02%12/10/13108318917.45%1591514414.68%84.13%60.55%3.17%
12/11/1337143649.80%284332517.65%78.02%12/11/132934716.04%272259.22%57.45%62.05%12.77%
12/12/13670768910.27%503654387.50%73.00%12/12/134848116.74%6846414.05%83.95%51.03%6.17%
12/13/1393498489.07%588545346.29%69.34%12/13/1384521825.80%179317621.18%82.11%91.07%4.13%
12/16/1320332216710.66%146211013527.19%67.47%12/16/13177526014.65%180617410.14%69.23%140.79%5.38%
12/17/13862787010.08%676835937.84%77.70%12/17/1387216218.58%127512214.56%78.40%131.49%8.02%
12/18/13766682010.70%594555397.75%72.44%12/18/1362413321.31%9258714.74%69.17%81.28%6.02%
12/19/13304333010.84%231202117.59%70.00%12/19/133125216.67%3633311.54%69.23%30.96%5.77%
12/20/13696474810.74%555555007.97%74.20%12/20/1363111618.38%8928714.10%76.72%91.43%7.76%
12/23/1318678218511.70%165116814838.84%75.56%12/23/13142327119.04%196119513.77%72.32%181.26%6.64%
12/24/13895799711.13%677586197.56%67.90%12/24/1380413717.04%111510613.81%81.02%101.24%7.30%
12/25/13ERROR:#DIV/0!0ERROR:#DIV/0!ERROR:#DIV/0!12/25/13ERROR:#DIV/0!0ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!
12/26/13835392611.09%602635397.21%65.01%12/26/1358210818.56%7146712.20%65.74%71.20%6.48%
12/27/13603478613.03%6635061310.99%84.35%12/27/1355711420.47%8968315.98%78.07%61.08%5.26%
12/30/1312952135410.45%946808667.30%69.87%12/30/13105823121.83%1941018418.34%83.98%171.61%7.36%
12/31/1379917068.83%449454045.62%63.60%12/31/135848815.07%553529.42%62.50%91.54%10.23%
Aug-102390243098912.96%222772012202659.32%71.89%Aug-1022192455720.53%3470397307315.64%76.15%3761.69%8.25%
Sep-102209582773112.55%197231757179668.93%71.12%Sep-1020135398019.77%2895129276614.38%72.74%3121.55%7.84%
Oct-102125782305610.85%168351763150727.92%73.02%Oct-1017716334718.89%2516117239914.20%75.17%2071.17%6.18%

FECA RTP Report Missing Provider Number * Missing Medicare Number Page &P of &N

DEEOIC RTP Volume

Energy HCFAEnergy UB
DateTotal Bills ReceivedTotal Bills RTP'd% Total Bills RTP'dRTP'd Prov # Combined

Lbryant: Lbryant:

Total number of bills that RTP'd for missing provider # or prov # & more than 1 reason RTP'd Missing Prov # & Other Reason RTP'd Missing Prov # Only Lbryant: Lbryant:

Bills RTP'd only for missing provider number in block 33 % Total Bills Received RTP Provider # % of RTP'd Provider # Date Total Bills Received Total Bills RTP'd % Total Bills RTP'd RTP'd Prov # Combined Lbryant: Lbryant:

Total number of bills that RTP'd for missing provider # or prov # & more than 1 reason RTP'd Missing Prov # & Other Reason RTP'd Missing Prov # Only Lbryant: Lbryant:

Bills RTP'd only for missing provider number in block 33 Lbryant: Lbryant:

Total number of bills that RTP'd for missing provider # or prov # & more than 1 reason Lbryant: Lbryant:

Bills RTP'd only for missing provider number in block 33 Lbryant: Lbryant:

Total number of bills that RTP'd for missing provider # or prov # & more than 1 reason% Total Bill Received RTP Provider #% of RTP Prov #RTP Medicare #% Total Bills Received RTP Medicare #% of RTP- Medicare #
12/02/13237938816.31%3043726712.78%78.35%12/02/1337911229.55%106310327.97%94.64%41.06%3.57%
12/03/13812678.25%443415.42%65.67%12/03/131741810.34%163139.20%88.89%42.30%22.22%
12/04/131201411.67%121210.00%85.71%12/04/134336.98%112.33%33.33%0.00%0.00%
12/05/135448515.63%7447013.60%87.06%12/05/131333627.07%2412318.05%66.67%21.50%5.56%
12/06/135896210.53%488408.15%77.42%12/06/13811316.05%121214.81%92.31%11.23%7.69%
12/09/13145018612.83%141131289.72%75.81%12/09/133608122.50%7066419.44%86.42%41.11%4.94%
12/10/13110813912.55%127612111.46%91.37%12/10/132114320.38%4233919.91%97.67%10.47%2.33%
12/11/13632528.23%375325.85%71.15%12/11/13531324.53%121222.64%92.31%0.00%0.00%
12/12/13534264.87%17173.18%65.38%12/12/1320315.00%3315.00%100.00%0.00%0.00%
12/13/13953798.29%739647.66%92.41%12/13/131923618.75%292915.10%80.56%21.04%5.56%
12/16/13200040620.30%3623632618.10%89.16%12/16/134048721.53%6816716.83%78.16%61.49%6.90%
12/17/131574654.13%401392.54%61.54%12/17/131012322.77%161615.84%69.57%32.97%13.04%
12/18/135179418.18%8838517.02%93.62%12/18/13743141.89%2712636.49%87.10%45.41%12.90%
12/19/133994511.28%361359.02%80.00%12/19/13961414.58%1411314.58%100.00%11.04%7.14%
12/20/13611619.98%587519.49%95.08%12/20/131441711.81%7164.86%41.18%10.69%5.88%
12/23/13124420416.40%156814812.54%76.47%12/23/132316528.14%5835525.11%89.23%20.87%3.08%
12/24/13787698.77%607537.62%86.96%12/24/131862815.05%2612513.98%92.86%21.08%7.14%
12/25/13ERROR:#DIV/0!0ERROR:#DIV/0!ERROR:#DIV/0!12/25/13ERROR:#DIV/0!0ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!
12/26/131563593.77%464422.94%77.97%12/26/131231915.45%1711613.82%89.47%0.00%0.00%
12/27/136559714.81%85107512.98%87.63%12/27/131863518.82%2922715.59%82.86%21.08%5.71%
12/30/13111313412.04%1181310510.60%88.06%12/30/131533623.53%2822618.30%77.78%42.61%11.11%
12/31/134838617.81%392378.07%45.35%12/31/13691724.64%1711624.64%100.00%11.45%5.88%
Aug-1017081248914.57%2153173198012.60%86.50%Aug-10259845117.36%3691435514.20%81.82%411.58%9.09%
Sep-1015725222514.15%1813118169511.53%81.48%Sep-10237153122.40%4511343819.02%84.93%271.14%5.08%
Oct-1020067241812.05%196517717889.79%81.27%Oct-10341373021.39%6223059218.22%85.21%441.29%6.03%

Energy RTP Report Missing Provider Number * Missing Medicare Number Page &P of &N

DCMWC RTP Volume

Black Lung HCFABlack Lung UB
DateTotal Bills ReceivedTotal Bills RTP'd% Total Bills RTP'dRTP'd Prov # Combined

Lbryant: Lbryant:

Total number of bills that RTP'd for missing provider # or prov # & more than 1 reason RTP'd Missing Prov # & Other Reason RTP'd Missing Prov # Only Lbryant: Lbryant:

Bills RTP'd only for missing provider number in block 33 % Total Bills RTP Provider # & other reason % of RTP'd Provider # Date Total Bills Received Total Bills RTP'd % Total Bills RTP'd RTP'd Prov # Combined Lbryant: Lbryant:

Total number of bills that RTP'd for missing prov # & more than 1 reason RTP'd Missing Prov # & Other Reason RTP'd Missing Prov # Only Lbryant: Lbryant:

Bills RTP'd only for missing provider number in block 33 Lbryant: Lbryant:

Total number of bills that RTP'd for missing provider # or prov # & more than 1 reason Lbryant: Lbryant:

Bills RTP'd only for missing provider number in block 33 Lbryant: Lbryant:

Total number of bills that RTP'd for missing prov # & more than 1 reason% Total Bill Received RTP-No Provider #% of RTP - Provider #
12/02/1391310911.94%103158811.28%94.50%12/02/131171714.53%2061417.09%117.65%
12/03/13871921.84%151517.24%78.95%12/03/134824.17%112.08%50.00%
12/04/138866.82%4134.55%66.67%12/04/1314214.29%117.14%50.00%
12/05/132043115.20%2312211.27%74.19%12/05/1350612.00%5510.00%83.33%
12/06/132465522.36%3452913.82%61.82%12/06/1360610.00%3125.00%50.00%
12/09/136007712.83%6185310.17%79.22%12/09/13701115.71%102814.29%90.91%
12/10/132405522.92%4624419.17%83.64%12/10/133538.57%3128.57%100.00%
12/11/132514718.73%183157.17%38.30%12/11/1322836.36%136759.09%162.50%
12/12/13250.00%00.00%ERROR:#DIV/0!12/12/13100.00%00.00%ERROR:#DIV/0!
12/13/134195813.84%4864211.46%82.76%12/13/13751216.00%1421218.67%116.67%
12/16/135678114.29%89197015.70%109.88%12/16/13651726.15%1631324.62%94.12%
12/17/1315385.23%553.27%62.50%12/17/1346510.87%4138.70%80.00%
12/18/132645721.59%48103818.18%84.21%12/18/1319631.58%6631.58%100.00%
12/19/131132320.35%2962325.66%126.09%12/19/1329310.34%226.90%66.67%
12/20/13671116.42%7710.45%63.64%12/20/1314214.29%2214.29%100.00%
12/23/1374716622.22%1534311020.48%92.17%12/23/131082523.15%3182328.70%124.00%
12/24/133384312.72%319229.17%72.09%12/24/137256.94%556.94%100.00%
12/25/13ERROR:#DIV/0!0ERROR:#DIV/0!ERROR:#DIV/0!12/25/13ERROR:#DIV/0!0ERROR:#DIV/0!ERROR:#DIV/0!
12/26/132824114.54%3423212.06%82.93%12/26/1337616.22%41310.81%66.67%
12/27/132324418.97%2912812.50%65.91%12/27/13311032.26%4412.90%40.00%
12/30/131972211.17%26101613.20%118.18%12/30/1316425.00%62437.50%150.00%
12/31/131903719.47%2712614.21%72.97%12/31/132627.69%00.00%0.00%
Aug-101006810068100.00%1578250132815.67%15.67%Aug-10158926516.68%1872516211.77%70.57%
Sep-1022878521522.79%4860573428721.24%93.19%Sep-10469689419.04%4996143810.63%55.82%
Oct-10622399015.91%83014268813.34%83.84%Oct-1096415215.77%1503311715.56%98.68%

Black Lung RTP Report Missing Provider Number Page &P of &N

File details come from the government source that posted it. Updated .