Skip to main content

Using Denial Analysis Data

Analysis  |  By Revenue Cycle Advisor  
   November 30, 2020

Performing denial analysis on a regular basis will enable you to identify the top reasons for denials and develop action plans to improve processes.

A version of this article was first published November 30, 2020, by HCPro's Revenue Cycle Advisor, a sibling publication to HealthLeaders.

Q: What kind of information can a denial analysis provide and how can we put it to use?

A: Performing denial analysis on a regular basis will enable you to identify the top reasons for denials and develop action plans to improve processes. Development of a denials database or tool to track denials will allow you to identify trends that can lead to process improvements such as the following:

Arrange claim adjustment reason codes into subcategories to identify the reason for denial, such as missing/invalid claim data, missing authorization, eligibility, medical necessity, etc. The subcategories allow for efficient research and review and help leaders to target improvement activities toward the functional area from which the denial is originating.

Revenue Cycle Advisor combines all of HCPro's Medicare regulatory and reimbursement resources into one handy and easy-to-access portal. News is not just repeated from other sources. It is analyzed by our Medicare experts so professionals can comprehend any new rule and regulatory updates thoroughly. Learn more.


Get the latest on healthcare leadership in your inbox.