decisionhealth Newsletters, Part B News - 2017 Issue 6 (June)
Specialties billing million-plus new-patient E/Ms mostly beat denial curse
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Article Overview
This benchmark article reviews how often major specialties billed outpatient new-patient E/M office visit services and how those claims fared under Medicare denial rates in 2015. It is useful for coders, billers, compliance staff, and specialty practices that track E/M utilization and claim outcomes, because it highlights broad denial-rate trends, high-volume specialty patterns, and comparative performance across major provider groups.
Why This Topic Matters
Understanding specialty-level denial patterns can help organizations benchmark their office visit billing activity and monitor whether their claim experience differs from national Medicare trends. The article supports revenue integrity, denial management, and utilization analysis for practices that commonly bill outpatient E/M services.
Article Sections
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Benchmark of the week
Introduces the article’s focus on Medicare denial patterns and volume trends for outpatient new-patient office visit E/M services across specialties.
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Utilization of outpatient E/Ms (99201-99205) for top specialties, 2015, with denial rates
Presents the specialty utilization benchmark referenced in the article and frames the comparison of high-volume outpatient E/M activity with denial outcomes.
What You Will Learn
- How the article frames Medicare denial trends for outpatient new-patient office E/M services.
- Which broad specialty groups are discussed in relation to high-volume office visit billing.
- How the article uses 2015 utilization and denial data as a benchmark for comparison.
- What types of practice groups are highlighted as major users of outpatient E/M services.
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Compliance teams
- Practice managers
- Specialty clinic administrators
Codes Discussed
Code Ranges Discussed
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