In a recent study by the Change Healthcare Healthy Hospital Revenue Cycle Index, it has been seen that 9 percent ($262 billion in charges) were initially denied out of the $ 3 trillion in claims that were submitted. For your average healthcare practice, it adds up to as much as 3.3 percent of NPR, dinging them for an average of $ 4.9 million and even more. Moreover, with the denial rate increasing on a daily basis, it is further becoming extremely essential to know the basics of denial management furthermore.
All about denials management for your HME billing:
Denial rate in your HME billing is the percentage of claims lines that come back denied each month on average which affect the reimbursement of the healthcare practices. In fact, here are the basic of how you can calculate HME billing metrics of a denial rate:
The denial rate = denials/ claim lines billed
For this KPI, you need to use the same date range for both metrics
A denial below 4 % in fact is the standard rate and up to 10% is considered as good,
10-15 % is ok
However, when a denial rate in a healthcare practice is more than 15 it's time to work on your denial management or look for a better outsourcing option for the same.
This is where Sunknowledge Services Inc, an operational extension providing complete HME pre and post billing solutions can help.
Sunknowledge Services Inc: help you reducing your denial rate and enhancing your HME billing metrics:
With years of experience and a holistic understanding of the claims and denial management process and the overall revenue management needs of a provider, Sunknowledge Services experts aids to gain business dividends by providing the best practices in place and quality. Ensuring regular follow up, stringent checks and balances, we further ensure a 99.9% accuracy rate reducing your chances of denial and ensuring timely claims submission.
With a complete understanding of present industry mandates and billing regulation, our experts today are one of the leading RCM known for the highest productivity metrics and seamless billing operation which has more than 100s of clientele list.
So if you are looking to improve your HME billing metrics, Sunknowledge experts are the one point destination for all your solution. For more information on our other benefits and how we can further help you with better ROI for your HME billing services, call us right now.