2/23/2026 2:24 AM
Financial Control (Payment) Summary
Claims Total Paid for Week
$3,846,716.27
Claims Total Paid YTD
$12,403,202.78
Claims Total Paid SFYTD
$28,277,785.87
Number Claims Processed YTD
21,976
Number Claims Processed SFYTD
65,158
Number Claims Processed for the Week
4,386
Number Claims Denied for the Week
347
Percent of Claims Denied for the Week
7.9
Add Pay Weekly Count
Beg. Inv.
Claims Rec'd
Claims 
Proc'd
End Inv.
Days on 
Hand
Add Pay Weekly Amount
CMS 1500
UB04
Members
ADA
Number of Members (Current Month)
18,729
Totals
Newly Eligible Members (Current Month)
100
Number of Members (Last Month)
19,396
Number Termed (Current Month)
12
Inventory
Received
Processed On Hand
Number Termed (Last Month)
767
0-10 Days
11-20
Provider Enrollment
21-30
Mailroom  ( TO BE DETERMINED )
Enrolled Providers
1,106
Over 30
On Island Providers
290
Totals
Off Island Providers
816
PayTo Providers
923
Credentialed
546
Provisional
538
Provider Updates Processed
32
CMS 1500
44
1,681
56
2,140
0
87.40
82
3,821
Number Termed Providers (Prev. Month)
4
UB04
2.4
10
97.6
402
0
93
93.10
412
Number of Termed Providers (Week)
0
ADA
100
153
0
0
0
56.90
74.20
153
Number of Providers on Pay Hold
5
Total Vol.
42
1,844
58
2,542
0
86.90
82.40
4,386
* Pharmacy
0
0
0
0
0
Prior Authorizations
PA's (Current Month)
16,284
PA's (Week)
187
Change Requests
Type
Submitted
Queued
Development
Resolved
SIT
Integrate
SIT
Test
UAT
Integrate
UAT
Test
PROD
Integrate
PROD
On Hold
OnGoing
PI_
Monitoring
Total
Billable
1
1
1
1
0
0
0
3
0
0
1
0
0
12
Non-Billable
0
2
5
2
0
0
0
0
1
0
2
2
0
14
Total CRs
1
3
6
3
0
0
0
3
1
0
3
2
0
26
Weekly CR
Submitted
Billable
0
Non-Billable
0
SOWs
Due to USVI
Billable
0
* YTD = Calendar Year to Date
* SFYTD = October 1 to September 30
Awaiting USVI
Closed
SOW_
Processing
% DDE 
Claims
90.70
98.50
54.30
90.10
4
0
4
0
0
% Paid 
in 30 Days
Processed in 
30 Days
% 
of Auto Adj.
Date of Oldest Batch
Total Paper Claims Processed
Reversal 
402
226
3,567
4,808
DDE Claim 
Vol.
% EDI 
Claims
EDI Claim Vol.
p
Claim 
Vol.
Total Paper Claims Received
Date of Oldest Batch
Reversal Replacements (Adjustments) and Voids   ( TO BE DETERMINED )
*Open & Void are excluded from 'Processed' Counts
* Pharmacy is not included in the Total Volume.  CIGNA processes Pharmacy claims through a PBM
USVI Dashboard for Week Ending 
Data Entry  ( TO BE DETERMINED )
In Process
Received
Closed
Provider Inquiry
EDI
Provider Enrollment
Recipient/Member
Call Center 
Total
Claims Processed
Total Volume
5
2/15/2026
0
1
0
0
613
0
1
0
0
0
0
0
0
Pends
Page 1 of 4
Government Provider's Financial Control (Payment) Summary
Weekending   
Provider Name
Claims Total 
Paid for Week
DOH, GOVERNMENT OF THE VI, CHARLES HARWOOD COMPLEX
$1,206.32
FREDERIKSTED HEALTH CARE, INC.
$204,345.77
GOVERNOR JUAN F LUIS HOSPITAL / ESRD
$54,894.47
GOVERNOR JUAN F. LUIS HOSPITAL AND MEDICAL CENTER
$36,166.43
MYRAH KEATING SMITH COMMUNITY HOSPITAL
$16,925.02
RLS COMMUNITY HEALTH CENTER
$0.00
ROY L. SCHNEIDER HOSPITAL
$147,558.18
ST THOMAS EAST END MEDICAL CENTER CORP
$30,305.45
2/15/2026
Claims Total 
Paid YTD
Claims Total 
Paid SFYTD
Number Claims 
Processed YTD
Number Claims 
Processed SFYTD
$19,979.28
$54,962.01
249
703
$1,633,406.66
$3,666,500.92
4,732
11,231
$118,369.53
$202,510.01
49
108
$398,963.16
$773,604.54
450
1,117
$32,944.63
$120,446.33
121
308
$0.00
$0.00
91
228
$1,807,777.58
$4,489,086.72
1,491
4,216
$242,498.87
$920,310.67
1,708
6,165
Number Claims 
Processed for the Week
Number Claims 
Denied for the Week
Percent of Claims 
Denied for the Week
21
2
9.5
1,028
4
0.3
7
0
0.0
76
5
6.5
13
1
7.6
1
1
100.0
294
5
1.7
397
1
0.2