Trends & Opportunities
Identify patterns across ATA and Random audits
Error Category Trend (12 Weeks)
Job Knowledge
Documentation
Accuracy
Communication
Error Distribution
Job Knowledge
UMR vs GEHA Scoring Differences
ATA — Score Adjustments
Avg UMR Score
Avg Adjusted Score
Random — Score Comparisons
UMR Score
GEHA Score
Disagree Rate by Category
| Category | ATA Disagrees | Random Disagrees | Avg Score Delta | 12-Week Trend |
|---|---|---|---|---|
| Job Knowledge | 42 | 28 | +8.3 |
|
| Documentation | 23 | 15 | +4.1 |
|
| Accuracy — Benefits | 18 | 12 | +6.7 |
|
| Communication | 11 | 8 | +3.2 |
|
| Accuracy — Eligibility | 9 | 7 | +5.1 |
Identified Opportunities
Job Knowledge — Claims Processing
37% of errors. UMR auditors consistently miss incorrect claim reprocessing decisions. Recommend targeted training.Documentation — Multi-Member Interactions
When multiple members are discussed, documentation is incomplete 62% of the time. Need process reminder.Advocacy — GEHA Website Mentions
Website mention compliance dropped 12% this month. Quick win for score improvement.Accuracy — Eligibility (Improving)
Down 23% from Q4. Prior coaching initiative showing results.Coaching Opportunities — Biweekly Tracker
| Period | Random Audits Sent | UMR Responded | Coaching Identified | Coaching Rate | Top Issue |
|---|---|---|---|---|---|
| Mar 1–14, 2026 | 42 | 38 | 12 | 31.6% | Job Knowledge |
| Feb 15–28, 2026 | 38 | 38 | 9 | 23.7% | Documentation |
| Feb 1–14, 2026 | 45 | 45 | 15 | 33.3% | Benefits Accuracy |
| Jan 15–31, 2026 | 40 | 40 | 11 | 27.5% | Job Knowledge |