Hopefully someone can confirm what I'm seeing.
In calculating CSR recoveries, I can start with a reasonably sized standard plan and drop ~90% of member months just because of the dollar restrictions imposed in determining credibility.
In other words, I can start with a plan with 50,000 member months. But because I can only count (toward credibility) policies with allowed > effective deductible and cost sharing < OOPM, I end up with 500 member months. Is anyone else seeing that?
Or do I need to go back to remedial math?
I humbly (and desperately) thank you in advance.
In calculating CSR recoveries, I can start with a reasonably sized standard plan and drop ~90% of member months just because of the dollar restrictions imposed in determining credibility.
In other words, I can start with a plan with 50,000 member months. But because I can only count (toward credibility) policies with allowed > effective deductible and cost sharing < OOPM, I end up with 500 member months. Is anyone else seeing that?
Or do I need to go back to remedial math?
I humbly (and desperately) thank you in advance.
CSR Credibility Standards