Denial Trends Today

Q1 2016 Review

The HME/DME market has experienced significant changes over the past few years which is 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 few Q1 highlights.

24%

Of HME/DME claims denied can be attributed to Eligibility reasons – down 2% compared to 2015


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

Q1 2016 Most Common Eligibility denial reason codes:

27: Expenses incurred after coverage terminated

31: Patient cannot be identified as insured

Most Commonly Denied Services
Up 5% from 2015 | Wheelchairs and Hospital Beds

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. 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