Physicians Practice - June 2008 - (Page 35) DENIAL RATE 5.72% 5.27% 6.33% 5.11% 7.45% 6.86% 6.41% 5.33% 7.61% 6.99% 6.82% 7.76% 9.22% 12.51% 7.56% 7.40% 11.69% 11.16% 7.73% 8.01% 11.88% 12.96% 7.20% 9.92% 9.97% 9.35% 10.01% 8.65% 9.17% 10.34% 9.69% 12.97% 15.24% 10.02% 10.55% 22.51% 32.92% 13.78% 22.93% 16.13% 23.46% 26.99% RANK 4 2 5 1 12 8 6 3 14 9 7 16 20 32 13 11 30 29 15 17 31 33 10 23 24 21 25 18 19 27 22 34 36 26 28 38 42 35 39 37 40 41 DENIAL TRANSPARENCY RANK 86.14% 89.96% 81.31% 83.51% 77.38% 78.22% 83.01% 77.05% 88.76% 83.62% 79.13% 83.34% 85.97% 63.23% 79.21% 78.83% 92.10% 79.93% 81.56% 84.69% 87.06% 81.79% 80.84% 80.64% 82.23% 80.07% 89.11% 82.50% 64.89% 76.20% 88.67% 85.05% 68.38% 81.89% 81.65% 72.30% 78.93% 71.41% 78.29% 88.95% 76.37% 80.92% 8 2 22 13 34 33 15 35 5 12 29 14 9 28 31 1 27 21 11 7 19 24 25 17 26 3 16 41 37 6 10 40 18 20 38 30 39 32 4 36 23 PERCENTAGE OF CLAIMS REQUIRING MEDICAL DOCUMENTATION 0.85% 0.84% 0.08% 1.60% 0.67% 1.54% 1.71% 1.15% 1.36% 2.03% 2.91% 2.11% 3.47% 0.52% 2.37% 1.93% 0.55% 1.48% 2.66% 1.69% 3.25% 4.48% 4.08% 2.26% 1.98% 2.55% 2.78% 3.49% 1.44% 7.71% 2.75% 1.31% 5.43% 1.64% 2.09% 2.33% 4.93% 10.36% 1.49% 14.03% 1.41% 6.34% RANK 6 5 1 15 4 14 18 7 9 21 31 23 33 2 26 19 3 12 28 17 32 36 35 24 20 27 30 34 11 40 29 8 38 16 22 25 37 41 13 42 10 39 PERCENTAGE OF NONCOMPLIANCE WITH CCI 0.37% 2.25% 0.37% 0.53% 0.27% 0.61% 0.56% 0.26% 0.13% 0.99% 0.40% 0.73% 0.51% 0.26% 0.45% 0.47% 0.26% 0.40% 0.44% 1.70% 1.66% 0.64% 2.24% 0.47% 0.64% 0.70% 0.20% 0.61% 0.17% 1.44% 0.57% 1.87% 0.05% 0.20% 0.30% 0.62% 0.09% 0.36% 1.31% 1.12% 1.16% 1.11% RANK 13 42 14 22 10 26 23 7 3 32 16 31 21 8 18 19 9 15 17 39 38 29 41 20 28 30 5 25 4 37 24 40 1 6 11 27 2 12 36 34 35 33 argues Smithson. Payment can be five to seven days faster. Shave another few days using electronic funds transfer, which enables payment to go right to the bank instead of directly to you in the form of a paper check, and we’re really talking about better performance. BOTTOM LINE taking you much longer to get paid or your denials are through the roof. Also, keep the data handy at contracting time. Even payers with high reimbursement might not be “good” payers for you if it takes 60 days or painful machinations to get the money from them. A quick note pointing out their lackluster performance relative to others might help. So, what does all this data mean for you? Look at where your payers stand, and take notice if they are doing worse by your practice. It might be that some of the problems are with your own processes if it’s WWW.PHYSICIANSPRACTICE.COM • Pamela Moore is senior editor, practice management, for Physicians Practice. She can be reached at pmoore@physicianspractice.com. JUNE 2008 | PHYSICIANS PRACTICE | 35 http://WWW.PHYSICIANSPRACTICE.COM
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