Rates and trends
Count and value together - one without the other misleads.
Denial rate (count)
33.7%
target 10% - lower is better
Denial rate (value)
27.5%
target 10% - lower is better
Remit denial rate
28.0%
target 9% - lower is better
Clean claim rate
66.0%
target 90% - higher is better
| Payer | Median days | Range | Claims |
|---|---|---|---|
| MERIDIAN HEALTH PLAN | 28 | 18-38 | 12,679 |
| NORTHSTAR MUTUAL | 41 | 25-58 | 12,462 |
| CASCADE CARE | 82 | 55-109 | 11,640 |
Charge lag - how long we take - median 6 days over 38,260 claims. A timely-filing denial is nearly always a charge-lag failure.
| Month | Clean | Denied | Denial rate |
|---|---|---|---|
| 202401 | 887.00 | 4,340.00 | 83.0% |
| 202402 | 16,473.75 | 17,948.25 | 52.1% |
| 202403 | 51,225.18 | 50,577.82 | 49.7% |
| 202404 | 69,337.89 | 43,460.11 | 38.5% |
| 202405 | 111,266.59 | 64,622.41 | 36.7% |
| 202406 | 133,511.93 | 83,234.07 | 38.4% |
| 202407 | 212,142.89 | 94,887.11 | 30.9% |
| 202408 | 262,123.86 | 97,868.14 | 27.2% |
| 202409 | 337,676.31 | 137,909.69 | 29.0% |
| 202410 | 319,103.22 | 139,062.78 | 30.4% |
| 202411 | 355,874.57 | 136,027.43 | 27.7% |
| 202412 | 382,093.00 | 167,268.00 | 30.4% |
| 202501 | 409,147.87 | 173,506.13 | 29.8% |
| 202502 | 361,943.27 | 174,522.73 | 32.5% |
| 202503 | 525,704.43 | 240,215.57 | 31.4% |
| 202504 | 446,470.11 | 203,224.89 | 31.3% |
| 202505 | 484,830.94 | 219,886.06 | 31.2% |
| 202506 | 496,985.47 | 245,103.53 | 33.0% |
| 202507 | 547,282.77 | 212,690.23 | 28.0% |
| 202508 | 693,792.14 | 242,456.86 | 25.9% |
| 202509 | 559,378.85 | 200,208.15 | 26.4% |
| 202510 | 540,556.70 | 178,749.30 | 24.9% |
| 202511 | 604,808.03 | 225,133.97 | 27.1% |
| 202512 | 509,040.51 | 195,838.49 | 27.8% |
| 202601 | 487,800.30 | 178,989.70 | 26.8% |
| 202602 | 497,693.31 | 172,785.69 | 25.8% |
| 202603 | 630,563.90 | 199,039.10 | 24.0% |
| 202604 | 515,473.36 | 172,176.64 | 25.0% |
| 202605 | 473,732.64 | 181,890.36 | 27.7% |
| 202606 | 493,821.63 | 132,426.37 | 21.1% |
| 202607 | 478,032.92 | 139,023.08 | 22.5% |
| 202608 | 557,395.90 | 199,534.10 | 26.4% |
| 202609 | 376,052.98 | 116,772.02 | 23.7% |
| Age | Denials | Denied | Share | Cumulative |
|---|---|---|---|---|
| not yet due | 0 | 0.00 | 0.0% | 0.0% |
| 0-30 | 458 | 172,193.36 | 3.6% | 3.6% |
| 31-60 | 418 | 155,089.41 | 3.2% | 6.8% |
| 61-90 | 366 | 139,365.22 | 2.8% | 9.6% |
| 91-180 | 1,373 | 512,555.51 | 10.7% | 20.3% |
| 180+ | 10,276 | 4,062,175.28 | 79.7% | 100.0% |