How Much Are Providers Losing to Admin Expenses Due to Denied Claims?
The recent Change Healthcare Healthy Hospital Revenue Cycle Index shows that denials are on the rise, with most being associated with front-end processes. This study found that up to 9 percent of claims are denied on their first submission. For example, 9% of the $3 trillion in claims submitted by hospitals in 2016 were initially denied. That's $262 billion overall, with individual hospitals at risk of losing $4.9 million from denials.  READ MORE
 DCI customers have zero billing errors and average denial rate is less than 3%!
Causes of Claim Denials 

Denials happen throughout the entire revenue cycle, but the largest percentages are related to front-end processes. Claims are denied for errors with:
  • Registration/eligibility - 23%
  • Missing/invalid claim data - 14.6%
  • Authorization/pre-certification of treatments/services - 12.4%
  • Missing medical documentation - 10.1%
  • Services not covered - 10.1%
  • Medical coding - 5.8%
  • Medical necessity - 5.8%
  • Untimely filing - 3.7%
  • Appropriateness of care - 3.4%


Reducing Denials of Claims 

The average cost to appeal a denial is $118, and it takes time to address the problem leading to the denial. Your best course of action is to prevent the problems leading to denials in the first place.

By keeping track of your clients' and care provider's information and alerting you to deficiencies in information, DCI's billing software can be the answer to reducing these risks.