Denial Trends Today
Q1 2017 Review
The HME/DME market has experienced significant changes over the past few years, which is in line with the healthcare industry as a whole. In the HME/DME space, we are seeing varying denial rates within different denial categories. Here are a few Q4 highlights.
Of HME/DME claims denied can be attributed to Eligibility reasons – up 3% compared to 2016.
Medicare is the payer leading to the greatest percentage of these Eligibility denials.
Q1 2017 Most Common Eligibility Denial Reason Codes:
204: Service/equipment/drug is not covered
27: Expenses incurred after coverage terminated
Most Commonly Denied Services
Up 2% from 2016 | Oxygen and Supplies
Leveraging comparative analytics, practices can compare data to peers and identify areas needing improvement.
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Resources for you:
* Information reported based on the HME/DME taxonomy classification for the 1st Quarter 2017