Denial Management Reports Reported in two parts, one for adjusted line items by adjustment reason by$ amount, the second by rejection reason (really, these are "zero payments" that have to be further investigated or transferred to the next responsible party) by count of instances. (For example, the Adjustment Report would list Adjustment reasons such as "Bundled Service", "Two E&M Services same day", "Courtesy Adjustment"... and the total $ amount; the Rejection report shows rejection categories such as "corrected insurance", "corrected Diagnosis", "corrected modifier", "Deductible", "non-covered service"... and the number of times this rejection has occurred in the course of the month.
Use this report for education and training purposes for the providers as well as for your staff, as it shows issues on a systemic level and can be a great tool to determine productivity for collectors as well. You can decrease your denial rates if you publish these rates to the providers and educate them individually on how to prevent your most common denials.
Pre-submission error reports summary which show the accuracy of data entry as well as the diligence of the staff in performing insurance verification and obtaining authorizations. It impacts the cash flow significantly if claims get "hung up" for incorrect data entry so make this one of your performance measures.
Turnaround times from Date of service to completion of progress note to billing to payment A great tool to inspire some competition among the providers to instill some urgency to complete outstanding visits if this is a problem for you.
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