decisionhealth Newsletters, Part B News - 2012 Issue 12 (December)
Benchmark of the Week: Initial patient upper-level E/M denial rates by specialty
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Article Overview
This article reviews Medicare-based benchmarking charts for upper-level initial patient evaluation and management office visit denials, comparing 2010 and 2011 results across the specialties that bill these services most often. It is useful for physicians, coders, practice managers, and revenue cycle staff who want to compare specialty-level denial performance and understand broader trends in upper-level office visit claims.
Why This Topic Matters
Upper-level initial patient E/M claims can represent significant revenue, so specialty-level denial benchmarking helps practices gauge performance and identify whether denial patterns are improving or lagging compared with national averages.
What You Will Learn
- How the article benchmarks upper-level initial patient E/M denial rates by specialty
- How denial-rate trends changed between 2010 and 2011
- Which specialties were highlighted in the Medicare claims analysis
- Why specialty-level denial benchmarking can matter to revenue performance
Who Should Read This
- Physicians
- Medical coders
- Coding auditors
- Practice managers
- Revenue cycle staff
- Billing departments
Codes Discussed
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