decisionhealth Newsletters, Part B News - 2011 Issue 12 (December)
Benchmark of the Week: Top 10 most damaging denials, 2009 vs. 2010
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Article Overview
This article reviews a benchmark comparison of denial patterns for a selected group of Medicare services, focusing on denial rates and dollar losses across 2009 and 2010. It is aimed at coding, billing, and revenue integrity audiences that monitor denial trends, service mix, and financial exposure across specialties. The discussion highlights the general comparison framework, the types of services analyzed, and the role of fee schedule context without exposing the underlying code-specific guidance.
Why This Topic Matters
Understanding which high-volume or high-dollar services are most affected by denials can help revenue cycle and coding teams prioritize monitoring and benchmarking efforts. The article is relevant for organizations evaluating financial risk across specialties and comparing performance over time.
What You Will Learn
- How denial-rate benchmarking is used to compare service performance over time.
- What types of services were included in the analysis and what kinds were excluded.
- How broad financial impact and utilization trends are presented in a denial-focused benchmark.
- Why certain specialty areas may be more exposed to financial loss from denials.
Who Should Read This
- Medical coders
- Billing specialists
- Revenue cycle managers
- Compliance teams
- Practice administrators
- Coding auditors
Codes Discussed
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