A denial rate is calculated by taking the total dollar amount of claims that have been denied by payers within a given time period and then dividing by the total dollar amount of claims submitted within the same time period.
- They represent a significant financial drain.
- According to market reports, denials costs healthcare organizations upto roughly 3 percent of their net revenue stream.
- High denial rates affects cash flow adversely.
- Non capture of tests or procedures
- Diagnosis and procedure coding errors and omissions
- Inaccurate clinical documentation
- Have had denials for over coding
- Are you past timely filing time limit
- Built-in coding compliance tool
- Complete audit trail to analyze the code and the related documentation
- Reconciliation between coder and CDI specialist
- Streamline and automate manual processes in coding and clinical documentation (CDI)
- Real-time tracking of coding and documentation activities
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