Benchmark: Denial rates for new patient visits by provider type, 2011 vs. 2012

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article examines denial-rate trends for new patient evaluation and management services across provider types, comparing specialists with primary care groups over two years. It is relevant to coding, billing, and revenue cycle professionals who want to understand how denial patterns differ by specialty group and service level, and how those patterns changed over time.

Why This Topic Matters

Denial-rate differences can affect reimbursement, billing workflow, and revenue performance, especially for high-volume E/M services. The article helps readers understand the scope of the comparison and the provider categories involved without requiring the full premium content.

What You Will Learn

  • How denial rates for new patient E/M services are compared across provider categories
  • Which provider groups are grouped into specialist and primary care categories for the analysis
  • How denial patterns changed between 2011 and 2012 at a high level
  • Why service-level denial trends matter for billing and revenue cycle review

Who Should Read This

  • Medical coders
  • Billing staff
  • Revenue cycle analysts
  • Practice managers
  • Physician administrators

Codes Discussed

Code Ranges Discussed


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