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Denial Codes in Medical Billing: Everything You Need to Know

Etactics

There are between 5 and 10 percent medical claim denials on average, according to the AAFP. In 2020, across HealthCare.gov insurers, reports show that 18 percent of in-network claims resulted in claim denials. These denial rates vary from individual providers as well. But what are denial codes? Let’s dive in.

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Denial Code CO 45: What it is and How to Get Help

Etactics

Knowing the different denial codes and what they stand for is just part of the equation. From claim scrubbing to real-time alerts on denials so you don’t have to wait weeks on insurance companies. One common occurrence that we see healthcare organizations struggling with is CO-45. What is a denial code?

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Denial Management in Healthcare: An Ultimate Guide

Etactics

Based on the total number of in-network claims submitted, that averaged out to a 17% denial rate. A more recent study found that the total denial rate increased by 3% more in 2022 than in 2021. But, in our 20+ years of business as a medical claims clearinghouse with a focus on denial management, we’ve noticed a pattern.

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Denial Code PR 31: What it is & How to Handle it

Etactics

When it comes to denial management in medical billing , the U.S. Healthcare Denial Management Markets , in 2021 denial management reached a value of $3.54 This is maybe obvious, but how about the fact that there is a growing number of medical claim denials? Let’s start by going over what a denial code even is.

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Denial Code CO16: Common RARCs and More

Etactics

86% of all healthcare claim denials are avoidable. Either way, the fact of the matter is that healthcare organizations can’t afford to forego the revenue associated with their avoidable claim denials. Insurance organizations tell you why they denied a specific claim by using a specific code. What is denial code CO16?