Forum - Questions & Answers

Apr 27th, 2014 - caseycarter

denied claim

what is the number one reason for a denied claim? Which is the most preventable denied claim?

Apr 28th, 2014 - shanbull 51 

re: denied claim

For this type of question I always check with Medicare first, for two reasons - one, they have the built-in claim checks and error rate testing so along with the most claims they also have the best data; and two, because private insurers tend to fall into Medicare guidelines on most issues eventually.

This is a great guide on the top claims errors for the NGS jurisdictions (sorry for the long link):!ut/p/a1/tZLNUsIwFIVfhU2XNLe0lOCuoO3I8KfIQLth0jYtYUhS0ijq05vqOOIoIxuzSu6cnJzv3qAErVEiyBMriWZSkH1zTvwNjBbDIOx6AJM-wG3gL8IoAtcDH61QgpJM6EpvUSzKmtOcZUTRTApNhbbgpGZBtieM1xZoWbU-9i2qlFSmlJKatn7UG_eKlDSnNSvF-yljOYqpg3GeY_Bc4nkUijTFRVEAxrTA2HeyRjmeDVA8J0q3BoYjbjjOrAAuwjwvmU07n4LzT8QmQ-_LYRaF18bBWYbDQTTFDw5aNB6r4WRzt7y5N-pTgMvJR3-xmF501GQ4KZvW6m2biUKi9Zn-GzHbHQ5JYKbcjPRZo_U_jNmEZim3jxm3we5h3On0DWG313V812tCBCJ1sUmsaEEVVfajMp9zq3VVX1lgwfF4tEspyz21M8kt-O3KVtYm_HclqjjHO5p2i8Wc8_m0naQv7uuYrt4A3WBc2g!!/dl5/d5/L2dBISEvZ0FBIS9nQSEh/?LOB=Part%20B

You can Google "top claim denials" but most of the articles just refer back to the same issues as Medicare, with less obvious data sources.

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