URSA-CORE-933: Claims or Bills with Negative Financial Amount

Measure Description

Among institutional claim or bill headers, professional claim or bill service line items, or pharmacy claims with at least one non-NULL allowed amount, plan paid amount, patient responsibility amount, or patient paid amount, the percentage with a negative amount in at least one of those fields.

Metadata

• Measure Type: Rate Measure
• Temporal Structure: Event
• Component Class: Normal-Form
• Denominator Case Field: Document ID
• Target Direction: Down

Denominator Description

One per institutional claim or bill headers, professional claim or bill service line items, or pharmacy claims with at least one non-NULL allowed amount, plan paid amount, patient responsibility amount, or patient paid amount.

Numerator Description

One per qualifying denominator observation with a negative allowed amount, plan paid amount, patient responsibility amount, or patient paid amount.