MI-BI: Denial Details

Summary:

 

·        Denials processed for the past 4 months by remit pay date.

·        Use page slicers to filter data.

·        Date slicers apply filters only to that page; other slicers sync between pages.

·        Reset to default settings by clicking the MI-BI logo.

·        Hover or click on specific charts and graphs for tooltips with summary information.

·        Cross-filter by clicking in charts to change the other visuals on the same page.

·        By default, common contractual denial codes are excluded.

·        Denials details are available on the last page of the report, “Details”, by right-clicking in the table/grid or within one of the charts and selecting “drillthrough”.

·        Right-click options include:

o   Drillthrough takes you to a page with standard slicers to filter data.

o   Show data displays details on the same page.

o   Include focuses chart to selected data element.

o   Exclude removes selected data from chart.

Top Reasons

 

  1. Actual date range included in this report.
  2. Top denial codes (claim adjustment and remittance reason codes) that are not excluded by default are ranked by total dollar amount denied.
  3. Average Days between Denial and Rebill Dates is the average number days to process denials. Actual days are counted.
  4. Average Days between Bill and Denial Dates is the average number of days to receive denials.
  5. Proportion of denials by group, excluding the codes omitted by default. Click a denial group to update the rest of the page. Right-click and drill through to view charge details.
  6. Review denials where an authorization was obtained (True) and submitted on the claim, or (False) when no authorization number was submitted.

 

Denials by Payor

 

  1. Table of top denials by total amount denied and the rank or frequency of denials by Patient Type. Drill down to Network, Collection Class and Insurance Carrier.
  2. Proportion of denials by group, excluding the codes omitted by default. Click a denial group to update the rest of the page. Right-click and drill through to view charge details.
  3. Waterfall chart shows the total denied amount by Patient Type. Drill down to review by Collection Class.

 

Denials by Dx/CPT

 

  1. Top CPT codes and Primary Diagnosis Codes denied by total dollar amount.
  2. Filter by one or more Payor Name, CPT code or Diagnosis Description by typing or selecting available options from drop-down list. Clear filters by clicking the eraser icon. 

Denials by Facility/Rdoc/Referral

 

  1. Denial totals by performing facility.
  2. Denial totals by rendering provider.
  3. Filter by one or more Payor Name or CPT code by typing or selecting available options from drop-down list. Clear filters by clicking the eraser icon. 

Details

 

  1. Charge-level detail for the preceding reports. Most useful when the drill through feature is used to focus on a specific subset of data. Click on a column header to sort by any column.
  2. Use the arrow to return to the previous page.