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
expedited_slower_than_standard warn 20 expedited turnaround exceeding standard high_denial_rate warn 11 rates far outside the peer range expedited_exceeds_standard_volume warn 10 transposed standard/expedited columns zero_denial_rate warn 7 0% denial reported std_headline_excludes_extended warn 1 extended-review cases outside the headline
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

std_headline_excludes_extended · 1 hit

extended-review cases outside the headline Show all 340
Plan
Severity
Rule
Detail
Medi-Cal Fee-for-Service (medical and behavioral health)
California DHCS · CA warn std_headline_excludes_extended headline approved/denied cover 78,145 of 78,987; the 842 balance is reported separately as extended review, so the published percentages understate the full population