Total rules
140
System
137
Suspect Reports
3
Pending review
2
| ID | Source | Business Description | Category | Dimension | Provider Type | # Records | Priority | Status | Action | |
|---|---|---|---|---|---|---|---|---|---|---|
| #17 | Suspect Reports | Individuals missing networks compared to other individuals within same group and specialty Probabilistic | Network | Completeness | Individuals | 500 | High | In Review APMC | ||
| #18 | Suspect Reports | Individual providers with active network and all reimbursements are terminated Probabilistic | Network | Consistency | Individuals | 50 | High | In Development | ||
| #128 | Suspect Reports | Individual providers missing networks when compared to similar providers Probabilistic | Network | Completeness | Individuals | 603 | High | Production APMCSR | ||
| #1 | System | Organization provider has no associated address Deterministic | Address | Completeness | Organization | 50 | High | Production | ||
| #2 | System | Organizations with Type 1 NPI but no relationships Deterministic | Relationships | Validity | Organization | 50 | High | Production | ||
| #3 | System | Orgs with Type 1 NPI that are NON SOLO practices Deterministic | Relationships | Validity | Organization | 50 | Medium | Production | ||
| #5 | System | Practice address without a valid remit Deterministic | Address | Completeness | Organization | 50 | High | Production | ||
| #7 | System | Organization provider is not associated with any network Deterministic | Network | Completeness | Organization | 50 | High | Production | ||
| #9 | System | Professional group that does not have any individual association Deterministic | Relationships | Completeness | Organization | 50 | High | Production | ||
| #10 | System | Individual provider does not have a RLTD_PADRS segment Deterministic | Address | Completeness | Individuals | 50 | High | Production | ||
| #12 | System | Individual provider does not have a specialty Deterministic | Profile | Completeness | Individuals | 13 | High | Production | ||
| #13 | System | Individuals w/o gender code Deterministic | Profile | Completeness | Individuals | 23 | Medium | Production | ||
| #15 | System | Individuals not credentialed Deterministic | Qualifications | Validity | Individuals | 50 | Medium | Production | ||
| #16 | System | PCP individuals having incorrect role code based on specialty and network Deterministic | Network | Accuracy | Individuals | 50 | High | Production | ||
| #19 | System | Organization providers with active network and all reimbursements are terminated Deterministic | Network | Consistency | Organization | 50 | High | Production | ||
| #20 | System | Individual providers with active network and having no reimbursements Deterministic | Network | Consistency | Individuals | 50 | High | Production | ||
| #21 | System | Organization providers with active network and having no reimbursements Deterministic | Network | Consistency | Organization | 50 | High | Production | ||
| #22 | System | Individual providers with multiple active addresses for same location Deterministic | Address | Consistency | Individuals | 50 | High | Production | ||
| #25 | System | Individual providers having network with incorrect display indicator Deterministic | Network | Accuracy | Individuals | 50 | High | Production | ||
| #31 | System | Individual providers having incorrect email address Deterministic | Address | Validity | Individuals | 43 | Medium | Production |
Showing 1–20 of 140 (total 140)
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SystemSuspect Reports