Denial Trends Today

Q4 2016 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.

24%

Of HME/DME claims denied can be attributed to Eligibility reasons – up 1% compared to 2015


Aetna is the payer leading to the greatest percentage of these Eligibility denials.

Q4 2016 Most Common Eligibility Denial Reason Codes:

204: Not covered under the patient’s plan

24: Capitation Agreement

Most Commonly Denied Services
Up 4% from 2015 | 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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Download the Denial Trends Today PDF