Claims Rejected (PI3383)

Number of claims submitted to the organization that were rejected during the reporting period.

Organizations should footnote all assumptions used, as well as the reasons for rejecting claims. See usage guidance for further information.

This metric is intended to capture the number of claims that were disqualified from benefit payment (in other words, rejected) for any reason.
Examples of reasons for which claims might be rejected, to footnote, include, among others, submission for uncovered events, submission before a waiting period has lapsed, or claim by an insured person who is no longer covered (due, for instance, to expiration of the coverage period or attainment of maximum eligible age).