decisionhealth Newsletters, Part B News - 2014 Issue 1 (January)
Benchmark: Denial rates by specialty for high-level, established E/M visits, 2010-2012
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Article Overview
This article summarizes denial-rate trends for high-level established office visit evaluation and management services across the specialties that billed them most often in 2012. It is intended for coding, billing, and revenue cycle professionals who track payer denials, specialty utilization, and year-over-year utilization patterns. The piece presents a comparison of denial rates by specialty over 2010 through 2012 and is useful for identifying where denial patterns were rising or changing across the reporting period.
Why This Topic Matters
Denial patterns for commonly billed established patient E/M services can affect specialty benchmarking, payer follow-up work, and revenue cycle monitoring. Understanding how denial rates changed across specialties and years helps organizations assess where denials were more prevalent and where trends differed from the overall pattern.
Article Sections
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Benchmark of the week
Introduces the benchmark topic and frames the article as a denial-rate comparison across specialties and reporting years.
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Denial rate trends by specialty
Summarizes the comparative denial-rate patterns across specialties for the established patient office visit services discussed in the article.
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99214 denial rates by specialty, 2010-2012
Presents the reported denial-rate comparison for one of the established patient office visit services across the specialties shown in the article.
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99215 denial rates by specialty, 2010-2012
Presents the reported denial-rate comparison for the other established patient office visit service across the specialties shown in the article.
What You Will Learn
- How the article frames denial-rate benchmarking for established patient office visit services
- Which specialties are discussed in the denial-rate comparison
- How the reporting period is structured across multiple years
- How denial trends are presented for high-level established E/M services
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle teams
- Practice managers
- Compliance staff
- Healthcare analysts
Codes Discussed
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