decisionhealth Newsletters, Part B News - 2010 Issue 11 (November)
Benchmark of the Week: Deviation in outpatient denials, 2008-2009
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Article Overview
This article reviews specialty-level denial patterns across two places of service and two years, highlighting how denial rates compared with baseline averages in office and outpatient hospital settings. It is intended for coding, billing, and reimbursement professionals who monitor denial performance trends, specialty variation, and place-of-service differences. The piece focuses on broad denial benchmarking, specialty comparisons, and an external reference to an OIG report discussed in context.
Why This Topic Matters
Understanding how denial patterns differ by specialty and place of service can help revenue cycle teams identify whether their results are typical or unusually high or low compared with broader benchmarks.
What You Will Learn
- How specialty denial rates were benchmarked across office and outpatient hospital settings.
- How denial performance differed by specialty and by year.
- Which types of specialties showed larger deviations from baseline denial trends.
- How an external OIG report is referenced in relation to outpatient infusion-related denials.
Who Should Read This
- Medical coders
- Billing specialists
- Revenue cycle managers
- Practice administrators
- Compliance professionals
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