Benefit Accuracy Measurement - Unemployment Insurance

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Appendix A IMPORTANT: Please enter each pay period end date and gross pay for each payday in the quarter. If the amounts for all weeks do not match the original amount reported by you – please call! BASE PERIOD YEAR – FROM ( / / ) TO ( / / ) Year/Quarter: Year/Quarter: PAY PERIOD BEGIN AND END DATES PAYDAY GROSS PAY PAY PERIOD BEGIN AND END DATES PAYDAY GROSS PAY TOTAL AUDITED TOTAL AUDITED CLAIM BENEFIT YEAR EARNINGS – FROM ( / / ) TO ( / / ) If you hired or rehired this person after the last date above, was this new hire reported to the New Hire Registry? Yes . If yes, when and to which state was the new hire reported __________ No . If no, explain why you did not report the claimant as a new hire ________________________________________ IMPORTAN T: Please enter each pay period end date and gross pay for each payday in the quarter. If the amounts for all weeks do not match the original amount reported by you – please call! PAY PERIOD BEGIN AND END DATES PAYDAY GROSS PAY PAY PERIOD BEGIN AND END DATES PAYDAY GROSS PAY TOTAL AUDITED TOTAL AUDITED I certify that the above information is correct to the best of my knowledge and belief. Employer’s signature: Title: Date: Official Use Only Auditor’s signature: Phone: Fax: Date Received: Form completed: BY FAX Employer is: BASE PERIOD ONLY Batch # Seq# A-11 July 2009
Database Description Appendix A Naming Conventions The DCA system utilizes the following naming conventions within the UI database: The base names are: • Each table will have a prefix of b-dca-xxxx. (The prefix's meaning is: 'b-' = Benefits Accuracy Measurement and 'dca-' = Denied Claims Accuracy. • Each table will have the same base name as the BAM PCA accuracy tables. comparison master errisu reopen assigndate The data characteristics table provides aggregate sample and population data for several demographic data elements. The primary table that consists of base record information. The error issue table contains information on the cause, responsibility, point of detection, and other data elements for improper denials. The reopen table contains a record of any modification to a master record after the record has been closed by the supervisor. The assignment table contains the investigator's case assignment information with respect to his/her master record. Paid Tables b-comparison b-master b-errisu b-assigndate b-reopen PAID CLAIMS ACCURACY TABLES Table Name Table Type Primary Primary Primary Primary Primary Denials Tables DENIED CLAIMS ACCURACY TABLES Table Name Table Type b-dca-comparison Primary b-dca-master Primary b-dca-errisu Primary b-dca-assigndate Primary b-dca-reopen Primary A-12 July 2009
Page 1 and 2: Benefit Accuracy Measurement Method
Page 3 and 4: BAM Integrity Rate Definitions The
Page 5 and 6: Quality Control Annual Report; 1996
Page 7 and 8: Appendix A PAID CLAIMS ACCURACY DAT
Page 9 and 10: Appendix A BENEFIT ACCURACY MEASURE
Page 11 and 12: Appendix A BENEFIT ACCURACY MEASURE
Page 13 and 14: Appendix A DENIED CLAIMS ACCURACY D
Page 15: Claimant Name: Appendix A Benefit A
Page 19 and 20: Appendix A BAM DATA ELEMENTS Data E
Page 21 and 22: _comparison cm39 smallint Samp Amt
Page 23: seq smallint seq smallint samptype

Benefit Accuracy Measurement - Unemployment Insurance

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