Denial Analysis: Preventable/Non-Preventable Denials
Denial Analysis: Preventable/Non-Preventable Denials
CARC codes can be designated Preventable or Non-Preventable. The Denial Analysis gives the opportunity to report on these separately which can help you create a better workflow for working A/R.
Preventable Denial/Processed As Primary
These are Denials that have been designated in CARC Management as a Denial that could have been prevented when the CARC is the Primary denial code.
- Grouped by CARC
- Encounters
- Number of Encounters: # Encounters with this CARC on the EOB.
- Percent of Denials: The CARC's percentage of all Encounter denials
- Percent of all Items: The CARC's percentage of all Encounters
- Claims
- Number of Claims: # Claims with this CARC on the EOB.
- Percent of Denials: The CARC's percentage of all Claim denials
- Percent of all Items: The CARC's % of all Claims
- Procedures
- Number of Procedures: # Procedures with this CARC on the EOB.
- Percent of Denials: The CARC's percentage of all Procedure denials
- Percent of all Items: % of all Procedures
- Allowed-Contracted: This is the contracted allowed amount that is loaded in your Allowed Fee Schedule. It is not the Allowed Amount on the EOB.
- PV (Preventable): Was this denial preventable? Y (Yes} or N (No)
- P (Primary): Was this the Primary CARC? Y (Yes} or N (No)
- Total Preventable Denials
Denial Analysis: Non-Preventable/Non-Primary CARC
These are Denials that have not been designated in CARC Management as a denial that could have been prevented where the CARC is not the Primary denial.
Top Denials
The Report can be run by top 5, 10, 25, 50, or 100 Denials.
Example Report: Top 10 Denial Codes
