Billing Monitor — DPSMF

DPSMF Billing Monitor

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Claims Today

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submitted

Avg Scrub Score

—

threshold 75

Denial Rate

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threshold 20%

Probe Audits

—

Aetna ADRs

NPI Mismatches

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credentialing gap

Upcoding Risk

—

score 0–100

Claims Volume

—

claims per tick · phase-adjusted

Scrub Score Avg

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warn <75 · critical <60

Denial Rate %

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warn >20% · critical >35%

Upcoding Risk Score

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warn >60 · critical >80

Probe Audit Accumulation

—

Aetna ADR count · same provider + CPT 99215

NPI Mismatch Count

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rendering vs billing NPI · credentialing gap

Recent Alerts 0

Time	Severity	Metric	Value	Threshold	Detail
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