Crossfoot
03 · Validation

Every filing checked against itself

CMS mandates publication. It does not mandate a format, does not require counts, and does not check arithmetic. 10 rules do.

All rules error warn info
Rule
Severity
Hits
Catches
std_counts_reconcile error 19 approved + denied ≠ stated total exp_counts_reconcile error 13 same, expedited appeals_exceed_total error 1 more overturns than appeals filed
23
of 536 filings publish numbers that do not reconcile against themselves
119
publish percentages with no counts at all
139
publish no appeal outcome
340
total findings across 536 filings

appeals_exceed_total · 1 hit

more overturns than appeals filed Show all 340
Plan
Severity
Rule
Detail
Sentara Health Plans - Medicare
Sentara Health · VA error appeals_exceed_total 134 overturned exceeds 127 appeals filed