decisionhealth Newsletters, Part B News - 2010 Issue 9 (September)
Benchmark of the Week: E/M denials by level and state, 2008
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Article Overview
This benchmark article examines evaluation and management denial rates by service level and geography using CMS claims data from 2008. It is aimed at coding, billing, and reimbursement professionals who want to understand how denial patterns vary by state, region, carrier, and service volume. The article presents a broad comparison of high- and low-denial states and discusses geographic trends alongside related Medicare utilization patterns.
Why This Topic Matters
Understanding where denial rates are higher or lower can help readers benchmark performance, spot geographic patterns, and frame reimbursement analysis in the context of Medicare claims data.
What You Will Learn
- How evaluation and management denial rates are compared across states and territories
- How denial patterns vary by service level and geographic region
- What the article reports about relationships among denial rates, carrier, and service volume
- How the data are positioned as a benchmark for reimbursement analysis
Who Should Read This
- Medical coders
- Coding auditors
- Billing managers
- Revenue cycle professionals
- Practice administrators
- Healthcare reimbursement analysts
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