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Rejection & Denial Analysis (Summary) Report

Summarized rejection and denial statistics at a glance. This report provides top-level metrics and trends to quickly identify problem areas. The Detailed version provides individual bill data for in-depth analysis.

The Rejection & Denial Analysis (Summary) Report provides a high-level overview of claim rejections and denials, highlighting key metrics and trends. This report is designed to quickly identify problem areas by surfacing the most common issues by payer, biller, and error type.

Running the Report

To run the report, enter a date range. The date range is limited to the last 2 years and can be configured using the Run Report By dropdown:

  1. Date of Rejection/Denial (default): Returns results based on the date of the rejection/denial.
  2. Date Billed: Returns results based on the date the bill was transmitted.
  3. Date of Service: Returns results based on the date of service of the bill.

The report can be filtered by Biller, Payer, and Error Type to focus on specific areas of concern.

Key Metrics

The report displays four summary metrics at the top:

  • Total Number of Bills Denied: Total count of bills with denials in the selected date range.
  • Financial Impact (Non-Resubmitted): Total charges for bills that have not been resubmitted.
  • Average Days to Resubmit: Average time taken to resubmit denied claims.
  • Resubmission Rate: Percentage of denied bills that have been resubmitted.

Top 10 Tables

The report includes three tables that identify the top sources of denials:

  1. Top 10 Denials by Payer: Shows the payers with the highest denial counts, including count, percentage, and dollar amount.
  2. Top 10 Denials by Biller: Shows the billers with the highest denial counts, including count, percentage, and dollar amount.
  3. Top 10 Denials by Error Description: Shows the most common error codes and descriptions, including count, percentage, and dollar amount.

These tables help identify patterns and prioritize efforts to reduce denials.