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.
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
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