Appendix_D_-_Extrapolation_Template_6-2015.xls
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Appendix D - Extrapolation Template 6-2015
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Universe Statistics
| Plan: | ||||||||||||
| Plan Year: | ||||||||||||
| UNIVERSE STATISTICS | ||||||||||||
| Instructions: | ||||||||||||
| Complete the blue and green colored items in the following table for the population of claims/services to be sampled. | ||||||||||||
| Figures shown in the template are for illustration only. Contractors will need to customize the following items to their particular Medicare cost plan universe: | ||||||||||||
| Number of strata (column 1) - Each cost report cost center could be a stratum, and if so then the stratum limits (column 2) would be the cost center name and not min/max dollar values. | ||||||||||||
| Also, if necessary certain cost centers could be further segregated into two or more strata by dollar values. | ||||||||||||
| Stratum min/max limits (column 2) - If stratum are determined by dollar value, customize the minimum and maximum stratum limits to the appropriate amounts for the particular universe. | ||||||||||||
| Green items (columns 4, 5, 6) should be input into RAT-STATS. | ||||||||||||
| RAT-STATS will calculate the optimal number of items to sample per stratum (enter in column 7). However, this statistically valid sample amount may not attain the total sample size set by CMS. | ||||||||||||
| In the fictional example below, only 215 items were included in the output from RAT-STATS, but the CMS sample size is 350. | ||||||||||||
| The minimum stratum sample size (column 8) must be considered to ensure enough coverage for each stratum. CMS sampling guidance states that this minimum is 30 items per stratum. | ||||||||||||
| The formula in column 9 determines whether the RAT-STATS output sample size met or exceeded the minimum stratum sample size. If 30 items was not met, the minimum of 30 is inserted. | ||||||||||||
| Note: If the total stratum universe is less than 30 items, the Contractor will need to change the formulas in columns 8-10 of that stratum to reflect that all items will be tested | ||||||||||||
| (column 11 sample items = column 6 items in universe) and the suggested minimum of 30 items will not be met. | ||||||||||||
| The formula in column 10 allocates the remaining required samples to the stratum based on the weighted value of the universe (column 3) so that the CMS minimum total sample size is met. | ||||||||||||
| The allocation may need to be adjusted due to rounding. In the example, the total number of samples in column 11 is 351, not 350. The column 10 allocation would need to be tweaked. | ||||||||||||
| The Contractor can also choose a different, rational method to allocate the remaining samples needed to get to the CMS total sample size. | ||||||||||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | ||
| RAT-STATS Inputs for Variable SVS | SVS Determination for Sample Selection | |||||||||||
| Stratum | Stratum Limits | Total Value of Universe | Standard Deviation | Mean | Total # of Items in Universe | RAT-STATS SVS Output | Minimum Stratum Size | Ratio Allocation | Allocated Additional Samples | Total # of Items in Sample | ||
| 1 | $0.00 | to | $249.99 | $41,038,006.25 | enter | enter | 181,345 | 72 | 30 | 72 | 35 | 107 |
| 2 | $250.00 | to | $999.99 | $38,655,882.65 | enter | enter | 19,827 | 57 | 30 | 57 | 33 | 90 |
| 3 | $1,000.00 | to | $3,499.99 | $24,667,061.46 | enter | enter | 4,894 | 42 | 30 | 42 | 21 | 63 |
| 4 | $3,500.00 | to | $14,999.99 | $20,224,637.94 | enter | enter | 1,281 | 27 | 30 | 30 | 17 | 47 |
| 5 | $15,000.00 | & up | $16,126,998.43 | enter | enter | 286 | 17 | 30 | 30 | 14 | 44 | |
| Total | $140,712,586.73 | 207,633 | 215 | 150 | 231 | 120 | 351 | |||||
| Minimum CMS Total Sample | 350 | |||||||||||
| NOTE: | According to Chapter 8, Section 4.2 of the Medicare Program Integrity Manual, | |||||||||||
| "If a particular probability sample design is properly executed, i.e., defining the universe, the frame, the sampling units, using proper randomization, accurately measuring the | ||||||||||||
| variables of interest, and using the correct formulas for estimation, then assertions that the sample and its resulting estimates are “not statistically valid” cannot legitimately | ||||||||||||
| be made. In other words, a probability sample and its results are always “valid.” Because of differences in the choice of a design, the level of available resources, and the | ||||||||||||
| method of estimation, however, some procedures lead to higher precision (smaller confidence intervals) than other methods." |
Audit Results
| Plan: | ||||||
| Plan Year: | ||||||
| REVIEW RESULTS | ||||||
| Instructions: | ||||||
| Complete the colored items in the following table for the population of claims/services to be sampled. | ||||||
| Green items will be input into RAT-STATS | ||||||
| Note: Figures shown in the template are for illustration only. | ||||||
| Claim Identifiers | MRC Findings | |||||
| Sample # | Stratum # | Claim # | Other Identifier | Examined Value | Audited Value | Difference Value |
| (e.g., line | (e.g., actual | (e.g., correct | error | |||
| number) | paid amount) | paid amount) | amount | |||
| 1 | 1 | 5555555 | 1 | $58.26 | $58.26 | $0.00 |
| 2 | 1 | 5555556 | 1 | $31.07 | $31.07 | $0.00 |
| 3 | 1 | 5555557 | 1 | $22.15 | $0.00 | $22.15 |
| 4 | 1 | 5555558 | 1 | $88.74 | $88.74 | $0.00 |
| 5 | 1 | 5555559 | 1 | $7.52 | $7.52 | $0.00 |
| 6 | 1 | 5555560 | 1 | $28.49 | $28.49 | $0.00 |
| 7 | 1 | 5555561 | 1 | $56.00 | $56.00 | $0.00 |
| 8 | 1 | 5555562 | 1 | $220.51 | $220.51 | $0.00 |
| 9 | 1 | 5555563 | 1 | $48.70 | $48.70 | $0.00 |
| 10 | 1 | 5555564 | 1 | $109.70 | $109.70 | $0.00 |
| 11 | 1 | 5555565 | 1 | $0.00 | $0.00 | $0.00 |
| 12 | 1 | 5555566 | 1 | $28.08 | $28.08 | $0.00 |
| 13 | 1 | 5555567 | 1 | $44.37 | $44.37 | $0.00 |
| 14 | 1 | 5555568 | 1 | $53.67 | $53.67 | $0.00 |
| 15 | 1 | 5555569 | 1 | $113.90 | $113.90 | $0.00 |
| 16 | 1 | 5555570 | 1 | $33.26 | $33.26 | $0.00 |
| 17 | 1 | 5555571 | 1 | $111.90 | $111.90 | $0.00 |
| 18 | 1 | 5555572 | 1 | $17.80 | $17.80 | $0.00 |
| 19 | 1 | 5555573 | 1 | $0.00 | $0.00 | $0.00 |
| 20 | 1 | 5555574 | 1 | $201.38 | $150.00 | $51.38 |
| 21 | 1 | 5555575 | 1 | $17.75 | $17.75 | $0.00 |
| 22 | 1 | 5555576 | 1 | $29.94 | $29.94 | $0.00 |
| 23 | 1 | 5555577 | 1 | $89.92 | $89.92 | $0.00 |
| 24 | 1 | 5555578 | 1 | $186.53 | $186.53 | $0.00 |
| 25 | 1 | 5555579 | 1 | $58.26 | $58.26 | $0.00 |
| 26 | 1 | 5555580 | 1 | $38.95 | $38.95 | $0.00 |
| 27 | 1 | 5555581 | 1 | $0.00 | $0.00 | $0.00 |
| 28 | 1 | 5555582 | 1 | $36.50 | $36.50 | $0.00 |
| 29 | 1 | 5555583 | 1 | $67.15 | $67.15 | $0.00 |
| 30 | 1 | 5555584 | 1 | $40.28 | $40.28 | $0.00 |
| 31 | 1 | 5555585 | 1 | $16.50 | $16.50 | $0.00 |
| 32 | 1 | 5555586 | 1 | $63.51 | $63.51 | $0.00 |
| 33 | 1 | 5555587 | 1 | $49.64 | $49.64 | $0.00 |
| 34 | 1 | 5555588 | 1 | $144.00 | $144.00 | $0.00 |
| 35 | 1 | 5555589 | 1 | $28.55 | $28.55 | $0.00 |
| 36 | 1 | 5555590 | 1 | $16.02 | $16.02 | $0.00 |
| 37 | 1 | 5555591 | 1 | $49.51 | $49.51 | $0.00 |
| 38 | 1 | 5555592 | 1 | $0.00 | $0.00 | $0.00 |
| 39 | 1 | 5555593 | 1 | $30.00 | $30.00 | $0.00 |
| 40 | 1 | 5555594 | 1 | $26.27 | $26.27 | $0.00 |
| 41 | 1 | 5555595 | 1 | $50.74 | $50.74 | $0.00 |
| 42 | 1 | 5555596 | 1 | $100.76 | $100.76 | $0.00 |
| 43 | 1 | 5555597 | 1 | $31.11 | $31.11 | $0.00 |
| 44 | 1 | 5555598 | 1 | $1.66 | $1.66 | $0.00 |
| 45 | 1 | 5555599 | 1 | $26.78 | $26.78 | $0.00 |
| 46 | 1 | $0.00 | ||||
| 47 | 1 | $0.00 | ||||
| 48 | 1 | $0.00 | ||||
| 49 | 1 | $0.00 | ||||
| 50 | 1 | $0.00 | ||||
| 51 | 1 | $0.00 | ||||
| 52 | 1 | $0.00 | ||||
| 53 | 1 | $0.00 | ||||
| 54 | 1 | $0.00 | ||||
| 55 | 1 | $0.00 | ||||
| 56 | 1 | $0.00 | ||||
| 57 | 1 | $0.00 | ||||
| 58 | 1 | $0.00 | ||||
| 59 | 1 | $0.00 | ||||
| 60 | 1 | $0.00 | ||||
| 61 | 1 | $0.00 | ||||
| 62 | 1 | $0.00 | ||||
| 63 | 1 | $0.00 | ||||
| 64 | 1 | $0.00 | ||||
| 65 | 1 | $0.00 | ||||
| 66 | 1 | $0.00 | ||||
| 67 | 1 | $0.00 | ||||
| 68 | 1 | $0.00 | ||||
| 69 | 1 | $0.00 | ||||
| 70 | 1 | $0.00 | ||||
| 71 | 1 | $0.00 | ||||
| 72 | 1 | $0.00 | ||||
| 73 | 1 | $0.00 | ||||
| 74 | 1 | $0.00 | ||||
| 75 | 1 | $0.00 | ||||
| 76 | 1 | $0.00 | ||||
| 77 | 1 | $0.00 | ||||
| 78 | 1 | $0.00 | ||||
| 79 | 1 | $0.00 | ||||
| 80 | 1 | $0.00 | ||||
| 81 | 1 | $0.00 | ||||
| 82 | 1 | $0.00 | ||||
| 83 | 1 | $0.00 | ||||
| 84 | 1 | $0.00 | ||||
| 85 | 1 | $0.00 | ||||
| 86 | 1 | $0.00 | ||||
| 87 | 1 | $0.00 | ||||
| 88 | 1 | $0.00 | ||||
| 89 | 1 | $0.00 | ||||
| 90 | 1 | $0.00 | ||||
| 91 | 1 | $0.00 | ||||
| 92 | 1 | $0.00 | ||||
| 93 | 1 | $0.00 | ||||
| 94 | 1 | $0.00 | ||||
| 95 | 1 | $0.00 | ||||
| 96 | 1 | $0.00 | ||||
| 97 | 1 | $0.00 | ||||
| 98 | 1 | $0.00 | ||||
| 99 | 1 | $0.00 | ||||
| 100 | 1 | $0.00 | ||||
| 101 | 1 | $0.00 | ||||
| 102 | 1 | $0.00 | ||||
| 103 | 1 | $0.00 | ||||
| 104 | 1 | $0.00 | ||||
| 105 | 1 | $0.00 | ||||
| 106 | 1 | $0.00 | ||||
| 107 | 1 | $0.00 | ||||
| 108 | 2 | 5555631 | 1 | $380.00 | $380.00 | $0.00 |
| 109 | 2 | 5555632 | 1 | $349.00 | $349.00 | $0.00 |
| 110 | 2 | 5555633 | 1 | $288.48 | $288.48 | $0.00 |
| 111 | 2 | 5555634 | 1 | $292.00 | $292.00 | $0.00 |
| 112 | 2 | 5555635 | 1 | $873.40 | $600.00 | $273.40 |
| 113 | 2 | 5555636 | 1 | $344.91 | $344.91 | $0.00 |
| 114 | 2 | 5555637 | 1 | $266.25 | $266.25 | $0.00 |
| 115 | 2 | 5555638 | 1 | $633.90 | $633.90 | $0.00 |
| 116 | 2 | 5555639 | 1 | $256.00 | $256.00 | $0.00 |
| 117 | 2 | 5555640 | 1 | $360.00 | $360.00 | $0.00 |
| 118 | 2 | 5555641 | 1 | $375.00 | $375.00 | $0.00 |
| 119 | 2 | 5555642 | 1 | $420.42 | $420.42 | $0.00 |
| 120 | 2 | 5555643 | 1 | $707.25 | $707.25 | $0.00 |
| 121 | 2 | 5555644 | 1 | $480.06 | $480.06 | $0.00 |
| 122 | 2 | 5555645 | 1 | $349.12 | $349.12 | $0.00 |
| 123 | 2 | 5555646 | 1 | $285.45 | $285.45 | $0.00 |
| 124 | 2 | 5555647 | 1 | $700.00 | $700.00 | $0.00 |
| 125 | 2 | 5555648 | 1 | $317.68 | $317.68 | $0.00 |
| 126 | 2 | 5555649 | 1 | $310.10 | $310.10 | $0.00 |
| 127 | 2 | 5555650 | 1 | $423.08 | $423.08 | $0.00 |
| 128 | 2 | 5555651 | 1 | $827.75 | $827.75 | $0.00 |
| 129 | 2 | 5555652 | 1 | $424.80 | $424.80 | $0.00 |
| 130 | 2 | 5555653 | 1 | $274.25 | $274.25 | $0.00 |
| 131 | 2 | 5555654 | 1 | $316.80 | $316.80 | $0.00 |
| 132 | 2 | 5555655 | 1 | $551.93 | $551.93 | $0.00 |
| 133 | 2 | 5555656 | 1 | $445.00 | $445.00 | $0.00 |
| 134 | 2 | 5555657 | 1 | $420.30 | $420.30 | $0.00 |
| 135 | 2 | 5555658 | 1 | $260.31 | $260.31 | $0.00 |
| 136 | 2 | 5555659 | 1 | $561.47 | $561.47 | $0.00 |
| 137 | 2 | 5555660 | 1 | $392.00 | $392.00 | $0.00 |
| 138 | 2 | $0.00 | ||||
| 139 | 2 | $0.00 | ||||
| 140 | 2 | $0.00 | ||||
| 141 | 2 | $0.00 | ||||
| 142 | 2 | $0.00 | ||||
| 143 | 2 | $0.00 | ||||
| 144 | 2 | $0.00 | ||||
| 145 | 2 | $0.00 | ||||
| 146 | 2 | $0.00 | ||||
| 147 | 2 | $0.00 | ||||
| 148 | 2 | $0.00 | ||||
| 149 | 2 | $0.00 | ||||
| 150 | 2 | $0.00 | ||||
| 151 | 2 | $0.00 | ||||
| 152 | 2 | $0.00 | ||||
| 153 | 2 | $0.00 | ||||
| 154 | 2 | $0.00 | ||||
| 155 | 2 | $0.00 | ||||
| 156 | 2 | $0.00 | ||||
| 157 | 2 | $0.00 | ||||
| 158 | 2 | $0.00 | ||||
| 159 | 2 | $0.00 | ||||
| 160 | 2 | $0.00 | ||||
| 161 | 2 | $0.00 | ||||
| 162 | 2 | $0.00 | ||||
| 163 | 2 | $0.00 | ||||
| 164 | 2 | $0.00 | ||||
| 165 | 2 | $0.00 | ||||
| 166 | 2 | $0.00 | ||||
| 167 | 2 | $0.00 | ||||
| 168 | 2 | $0.00 | ||||
| 169 | 2 | $0.00 | ||||
| 170 | 2 | $0.00 | ||||
| 171 | 2 | $0.00 | ||||
| 172 | 2 | $0.00 | ||||
| 173 | 2 | $0.00 | ||||
| 174 | 2 | $0.00 | ||||
| 175 | 2 | $0.00 | ||||
| 176 | 2 | $0.00 | ||||
| 177 | 2 | $0.00 | ||||
| 178 | 2 | $0.00 | ||||
| 179 | 2 | $0.00 | ||||
| 180 | 2 | $0.00 | ||||
| 181 | 2 | $0.00 | ||||
| 182 | 2 | $0.00 | ||||
| 183 | 2 | $0.00 | ||||
| 184 | 2 | $0.00 | ||||
| 185 | 2 | $0.00 | ||||
| 186 | 2 | $0.00 | ||||
| 187 | 2 | $0.00 | ||||
| 188 | 2 | $0.00 | ||||
| 189 | 2 | $0.00 | ||||
| 190 | 2 | $0.00 | ||||
| 191 | 2 | $0.00 | ||||
| 192 | 2 | $0.00 | ||||
| 193 | 2 | $0.00 | ||||
| 194 | 2 | $0.00 | ||||
| 195 | 2 | $0.00 | ||||
| 196 | 2 | $0.00 | ||||
| 197 | 2 | $0.00 | ||||
| 198 | 3 | 3489061 | $2,249.80 | $2,249.80 | $0.00 | |
| 199 | 3 | 3479567 | $1,665.54 | $1,665.54 | $0.00 | |
| 200 | 3 | 3470073 | $3,114.49 | $3,114.49 | $0.00 | |
| 201 | 3 | 3460579 | $2,717.87 | $2,717.87 | $0.00 | |
| 202 | 3 | 3451085 | $2,130.75 | $2,130.75 | $0.00 | |
| 203 | 3 | 3441591 | $2,484.80 | $2,484.80 | $0.00 | |
| 204 | 3 | 3432097 | $1,893.30 | $1,893.30 | $0.00 | |
| 205 | 3 | 3422603 | $1,187.55 | $1,187.55 | $0.00 | |
| 206 | 3 | 3413109 | $1,605.08 | $1,605.08 | $0.00 | |
| 207 | 3 | 3403615 | $1,408.95 | $1,408.95 | $0.00 | |
| 208 | 3 | 3394121 | $1,400.00 | $1,400.00 | $0.00 | |
| 209 | 3 | 3384627 | $1,435.00 | $1,435.00 | $0.00 | |
| 210 | 3 | 3375133 | $1,080.00 | $1,080.00 | $0.00 | |
| 211 | 3 | 3365639 | $2,756.25 | $2,756.25 | $0.00 | |
| 212 | 3 | 3356145 | $1,498.04 | $1,498.04 | $0.00 | |
| 213 | 3 | 3346651 | $1,075.00 | $1,075.00 | $0.00 | |
| 214 | 3 | 3337157 | $3,245.62 | $3,245.62 | $0.00 | |
| 215 | 3 | 3327663 | $1,047.12 | $1,047.12 | $0.00 | |
| 216 | 3 | 3318169 | $2,245.30 | $2,245.30 | $0.00 | |
| 217 | 3 | 3308675 | $3,078.18 | $3,078.18 | $0.00 | |
| 218 | 3 | 3299181 | $2,392.69 | $2,392.69 | $0.00 | |
| 219 | 3 | 3289687 | $1,679.08 | $1,679.08 | $0.00 | |
| 220 | 3 | 3280193 | $1,141.00 | $1,141.00 | $0.00 | |
| 221 | 3 | 3270699 | $2,290.00 | $2,290.00 | $0.00 | |
| 222 | 3 | 3261205 | $1,950.00 | $1,950.00 | $0.00 | |
| 223 | 3 | 3251711 | $1,988.80 | $1,988.80 | $0.00 | |
| 224 | 3 | 3242217 | $1,125.00 | $1,125.00 | $0.00 | |
| 225 | 3 | 3232723 | $1,030.00 | $1,030.00 | $0.00 | |
| 226 | 3 | 3223229 | $1,260.00 | $1,260.00 | $0.00 | |
| 227 | 3 | 3213735 | $2,705.40 | $2,705.40 | $0.00 | |
| 228 | 3 | 3204241 | $2,353.55 | $1,368.00 | $985.55 | |
| 229 | 3 | 3194747 | $1,092.84 | $1,092.84 | $0.00 | |
| 230 | 3 | 3185253 | $2,955.29 | $2,955.29 | $0.00 | |
| 231 | 3 | 3175759 | $1,035.00 | $1,035.00 | $0.00 | |
| 232 | 3 | $0.00 | ||||
| 233 | 3 | $0.00 | ||||
| 234 | 3 | $0.00 | ||||
| 235 | 3 | $0.00 | ||||
| 236 | 3 | $0.00 | ||||
| 237 | 3 | $0.00 | ||||
| 238 | 3 | $0.00 | ||||
| 239 | 3 | $0.00 | ||||
| 240 | 3 | $0.00 | ||||
| 241 | 3 | $0.00 | ||||
| 242 | 3 | $0.00 | ||||
| 243 | 3 | $0.00 | ||||
| 244 | 3 | $0.00 | ||||
| 245 | 3 | $0.00 | ||||
| 246 | 3 | $0.00 | ||||
| 247 | 3 | $0.00 | ||||
| 248 | 3 | $0.00 | ||||
| 249 | 3 | $0.00 | ||||
| 250 | 3 | $0.00 | ||||
| 251 | 3 | $0.00 | ||||
| 252 | 3 | $0.00 | ||||
| 253 | 3 | $0.00 | ||||
| 254 | 3 | $0.00 | ||||
| 255 | 3 | $0.00 | ||||
| 256 | 3 | $0.00 | ||||
| 257 | 3 | $0.00 | ||||
| 258 | 3 | $0.00 | ||||
| 259 | 3 | $0.00 | ||||
| 260 | 3 | $0.00 | ||||
| 261 | 4 | $0.00 | ||||
| 262 | 4 | $0.00 | ||||
| 263 | 4 | $0.00 | ||||
| 264 | 4 | $0.00 | ||||
| 265 | 4 | $0.00 | ||||
| 266 | 4 | $0.00 | ||||
| 267 | 4 | $0.00 | ||||
| 268 | 4 | $0.00 | ||||
| 269 | 4 | 589647 | $7,151.27 | $7,140.00 | $11.27 | |
| 270 | 4 | $0.00 | ||||
| 271 | 4 | $0.00 | ||||
| 272 | 4 | $0.00 | ||||
| 273 | 4 | $0.00 | ||||
| 274 | 4 | $0.00 | ||||
| 275 | 4 | $0.00 | ||||
| 276 | 4 | $0.00 | ||||
| 277 | 4 | $0.00 | ||||
| 278 | 4 | $0.00 | ||||
| 279 | 4 | $0.00 | ||||
| 280 | 4 | $0.00 | ||||
| 281 | 4 | $0.00 | ||||
| 282 | 4 | $0.00 | ||||
| 283 | 4 | $0.00 | ||||
| 284 | 4 | $0.00 | ||||
| 285 | 4 | $0.00 | ||||
| 286 | 4 | $0.00 | ||||
| 287 | 4 | $0.00 | ||||
| 288 | 4 | $0.00 | ||||
| 289 | 4 | $0.00 | ||||
| 290 | 4 | $0.00 | ||||
| 291 | 4 | $0.00 | ||||
| 292 | 4 | $0.00 | ||||
| 293 | 4 | $0.00 | ||||
| 294 | 4 | $0.00 | ||||
| 295 | 4 | $0.00 | ||||
| 296 | 4 | $0.00 | ||||
| 297 | 4 | $0.00 | ||||
| 298 | 4 | $0.00 | ||||
| 299 | 4 | $0.00 | ||||
| 300 | 4 | $0.00 | ||||
| 301 | 4 | $0.00 | ||||
| 302 | 4 | $0.00 | ||||
| 303 | 4 | $0.00 | ||||
| 304 | 4 | $0.00 | ||||
| 305 | 4 | $0.00 | ||||
| 306 | 4 | $0.00 | ||||
| 307 | 4 | $0.00 | ||||
| 308 | 5 | $0.00 | ||||
| 309 | 5 | $0.00 | ||||
| 310 | 5 | $0.00 | ||||
| 311 | 5 | $0.00 | ||||
| 312 | 5 | $0.00 | ||||
| 313 | 5 | $0.00 | ||||
| 314 | 5 | $0.00 | ||||
| 315 | 5 | $0.00 | ||||
| 316 | 5 | $0.00 | ||||
| 317 | 5 | $0.00 | ||||
| 318 | 5 | $0.00 | ||||
| 319 | 5 | $0.00 | ||||
| 320 | 5 | $0.00 | ||||
| 321 | 5 | $0.00 | ||||
| 322 | 5 | $0.00 | ||||
| 323 | 5 | $0.00 | ||||
| 324 | 5 | $0.00 | ||||
| 325 | 5 | $0.00 | ||||
| 326 | 5 | $0.00 | ||||
| 327 | 5 | $0.00 | ||||
| 328 | 5 | $0.00 | ||||
| 329 | 5 | $0.00 | ||||
| 330 | 5 | $0.00 | ||||
| 331 | 5 | $0.00 | ||||
| 332 | 5 | $0.00 | ||||
| 333 | 5 | $0.00 | ||||
| 334 | 5 | $0.00 | ||||
| 335 | 5 | $0.00 | ||||
| 336 | 5 | $0.00 | ||||
| 337 | 5 | $0.00 | ||||
| 338 | 5 | $0.00 | ||||
| 339 | 5 | $0.00 | ||||
| 340 | 5 | $0.00 | ||||
| 341 | 5 | $0.00 | ||||
| 342 | 5 | $0.00 | ||||
| 343 | 5 | $0.00 | ||||
| 344 | 5 | $0.00 | ||||
| 345 | 5 | $0.00 | ||||
| 346 | 5 | $0.00 | ||||
| 347 | 5 | $0.00 | ||||
| 348 | 5 | $0.00 | ||||
| 349 | 5 | $0.00 | ||||
| 350 | 5 | 5326124 | 1 | $16,452.00 | $16,452.00 | $0.00 |
Error Rate Calc
| Plan: | ||||||||
| Plan Year: | ||||||||
| ERROR RATE CALCULATION | ||||||||
| Instructions: | ||||||||
| Ensure the formulas below are pulling the correct amounts and the results make sense. | ||||||||
| If the Total Financial Error Rate is 1% or more, enter the Point Estimate and the 90% Lower Confidence Limit from RAT-STATS. | ||||||||
| This will provide the total extrapolated adjustment, but this amount still must be allocated to the strata in order to adjust the cost report. | ||||||||
| Adjustments should be made to both the costs and statistics reported on the cost report. | ||||||||
| Total Net Error Rate | ||||||||
| Sample | Sample | Sample | Stratum | Total Value | ||||
| Stratum | Stratum Limits | Size | Error | Value | Error Rate | of Universe | ||
| 1 | $0.00 | to | $249.99 | 107 | $73.53 | $2,475.83 | 3.0% | $41,038,006.25 |
| 2 | $250.00 | to | $999.99 | 90 | $273.40 | $12,886.71 | 2.1% | $38,655,882.65 |
| 3 | $1,000.00 | to | $3,499.99 | 63 | $985.55 | $64,317.29 | 1.5% | $24,667,061.46 |
| 4 | $3,500.00 | to | $14,999.99 | 47 | $11.27 | $7,151.27 | 0.2% | $20,224,637.94 |
| 5 | $15,000.00 | & up | 44 | $0.00 | $16,452.00 | 0.0% | $16,126,998.43 | |
| TOTAL | 351 | $1,343.75 | $103,283.10 | $140,712,586.73 | ||||
| Total Financial Error Rate (Weighted) | 1.7% | |||||||
| Is the error rate material? | Yes | |||||||
| If material, calculate extrapolated values using RATSTAT or equivalent software: | ||||||||
| Best Estimate (Point Estimate) | ||||||||
| Report the larger of: | ||||||||
| Sample Error | $1,343.75 | |||||||
| OR | ||||||||
| 90% Lower Confidence Limit (two-tailed test) for the Total Error |
File details come from the government source that posted it. Updated .