I spy new data on the HME News Databank page


So in case you didn't notice, the Databank page in the April issue of HME News featured some new data courtesy of the folks at RemitData.

Each month, the Databank page features a RemitData Denial Tracker that shows the percentage of Medicare claims rejected on a monthly basis for three product categories: rehab, DME and respiratory. This data is based on a pretty good sized pool of claims. For the month of February, 1,828,268 of them to be exact.

In April, the graph also featured the percentage of commercial claims rejected on a monthly basis for those same three product categories, based on 1,439,933 claims.

The result:

I see a number of ways this new graph should prove useful. One way: For providers who are looking to distance themselves from Medicare (and who isn't?), it gives them some idea of what they're getting into. Reimbursement aside, it looks like the denial rates for commercial payers are a bit lower than Medicare, especially for respiratory, which had a denial rate in February of 18.3% for Medicare and 13.4% for commercial payers. That's a good thing.

It's not so clear cut for rehab and DME. While the denial rate for rehab in February for Medicare was higher than the denial rate for commercial payers, those roles were reversed in March 2010. Same thing for DME in March 2010 and January 2010.

Another way: How does your company's denial rates stack up against these national averages? Better? Worse? What's that mean for your business?

I'll be keeping track of this data each month—so should you.

Liz Beaulieu