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 Q1 highlights.

21%

Of HME/DME claims denied can be attributed to Eligibility reasons – down 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.

Get the tools you need to put these steps into action. Visit our website and watch a quick video to learn more about healthcare comparative analytics.

Resources for you:

  • ICD-10 Resource Center: Follow the latest trends and learn how others are dealing with ICD-10.
  • Compare Your Data: View denial rates by specialty in your state and see how you compare to the industry average
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* Information reported based on the HME/DME taxonomy classification for the 1st Quarter 2017

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