decisionhealth Newsletters, Part B News - 2009 Issue 9 (September)
Benchmark of the Week: Denials by place of service, 2006-2007
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Article Overview
This article summarizes a benchmark chart from a Part B News analysis of CMS claims data, focusing on how denial rates changed by place of service between 2006 and 2007. It is relevant to coding, billing, and revenue cycle professionals who monitor utilization and denial trends across settings such as office, inpatient hospital, and skilled nursing facility. The discussion stays at a high level and is centered on service-setting comparisons, overall utilization patterns, and the broader mix of imaging services included in the analysis.
Why This Topic Matters
Denial trends by place of service can affect reimbursement monitoring, operational benchmarking, and comparison of service-setting performance over time. Understanding the scope of the chart helps readers decide whether the underlying CMS-based analysis is useful for their own billing or coding workflow.
What You Will Learn
- How denial rates are compared across service settings over time.
- What types of imaging services were included in the benchmark analysis.
- Which broad places of service were emphasized in the chart.
- How CMS claims data was used as the basis for the analysis.
Who Should Read This
- Medical coders
- Billing specialists
- Revenue cycle professionals
- Practice managers
- Healthcare analysts
Codes Discussed
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