13 Apr 2010 Casey Kozee 2 Comments
Most providers and billing professionals understand the importance of tracking a practice’s “denied” claims—those for which insurers refuse to pay a dime. But there are other “hidden denials” that you also should be monitoring to prevent a slower, less obvious revenue drain.
I recently ran a report sampling more than five million claims and remits from late 2009, and found that about 7% were denied outright by payers. This is what I would call a traditional “denial” rate. Payers didn’t reimburse for any of the services on these claims.
A closer look at the denied 7% reveals that they cut across all types of diagnoses, from routine exams and vaccinations to cataracts and hypertension.
