decisionhealth Newsletters, Part B News - 2012 Issue 12 (December)
Benchmark of the Week: Established patient upper-level E/M denial rates by specialty
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Article Overview
This benchmark article summarizes denial-rate data for upper-level established patient office visit evaluation and management services, organized by specialty and compared across 2010 and 2011. It is aimed at coding, billing, and practice management readers who want to compare their own denial performance with specialty-level trends and understand the general context of Medicare claims analysis featured by Part B News.
Why This Topic Matters
It helps readers gauge whether denial patterns for higher-level established patient E/M office visits are aligned with specialty benchmarks and why those denials can be financially significant.
What You Will Learn
- How denial-rate benchmarks are presented for established patient office visit E/M services
- How the data are organized by specialty and year
- What broad trends were observed in upper-level E/M denial rates
- Why denial performance matters for higher-level office visit claims
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Revenue cycle professionals
- Physician offices
Codes Discussed
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