ICD-10 claims denial rate at 1.6 percent, RelayHealth reports

Posted by ddeardorff
February 29, 2016
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Denial rates for ICD-10 claims are at about 1.6 percent, according to a report by RelayHealth Financial.Stethdollar 360 360 90

Out of about 262 million claims processed between Oct. 1, 2015, and Feb. 15, 2016, which totaled $810 billion, 1.6 percent were denied, according to an announcement from the revenue cycle management solutions organization.

The numbers show there has not been a “marked increase” in rates for claim denials, Marcy Tatsch, RelayHealth Financial’s vice president and general manager of reimbursement solutions, says in the announcement.

However, she adds that “as many as 1 in 5 claims is still denied or delayed–which can mean a dip of as much as 3 percent in a hospital or health system’s revenue stream.”

The Centers for Medicaid & Medicare Services, in a recent blog post by Acting Administrator Andy Slavitt, posted 2015 ICD-10 claims rejections, based on estimates from testing. CMS found that an average of 9.9 percent of claims were denied; the RelayHealth Financial’s reported rate of 1.6 percent shows actual rates may be lower than those averages.

Slavitt says in the post that while CMS is continually improving and won’t “declare victory,” the fears surrounding implementation of ICD-10 never materialized.

The implementation had been delayed three times, including once by Congress, before it was finally official last fall.

To learn more:
– here’s the announcement

Source:  FierceHealth IT | Katie Dvorak

2/29/16

 

**A special note from MediPro, Inc.:  The RelayHealth Clearinghouse is one of our preferred products for Eligibility, Claims, ERA and Financial Analytics performance.  With a market proven reputation and additional tools for Billers to utilize, we encourage you to explore RelayHealth especially if your practice has a relatively updated version of the Lytec Practice Management software.

 

 

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