decisionhealth Newsletters, Part B News - 2010 Issue 6 (June)
Benchmark of the Week: Denials and revenue lost per provider
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Article Overview
This article reviews a benchmark chart that compares specialties by denials per provider and estimated revenue lost from denials. It explains how the analysis was constructed from Medicare claims data and discusses why certain specialties appear more affected than others. The piece is aimed at coding, billing, and revenue cycle professionals who want to understand specialty-level denial patterns and financial impact at a high level.
Why This Topic Matters
Denials can affect revenue differently depending on specialty volume and average payment levels. This article helps readers interpret benchmark data used for comparing specialties and understanding where denial-related financial risk may be greatest.
What You Will Learn
- How denial benchmarks can be expressed on a per-provider basis
- How specialty-level denial counts relate to estimated revenue impact
- How Medicare utilization and claims data were used to frame the analysis
- Why denial impact may differ between primary care and higher-value procedural specialties
Who Should Read This
- Medical coders
- Billers
- Revenue cycle staff
- Practice administrators
- Healthcare finance professionals
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