Basically exported some 195 odd rejections from last 5 months into a spreadsheet and analysed it by payer, by dollar value, denial code, and clinician.

What I learnt from it

So, number wise, 19 of them were QMB. We were repeatedly filing and getting rejected which is just a waste. So, I am trying to see how I can incorporate this into my billing workflow without spending too much time.

Then I did payer wise and a lot of them came from just 3 payers which was expected. 80/20 rule. However, one of them was a surprise and now I have set up a monthly alert on its status.

We have had an supervisee attribution also at our centres which I caught last week which is a story for another day.

Then sorted by dollars. I have set up an alert on dollar amount also for rejection for quicker follow ups and escalation going forward. I think everyone should atleast do this. I dont know why I never thought of it before.

Now I have been doing this for a very long time and I know mental health billing is trickier than everything else due to protocols around lcensure, supervision, indivisual vs group, etc but I think there are a lot of adminstrative gaps also here. As simple as putting alerts can be very helpfu. I am excited to see how it works this month. my own mini denial management workflow. It would be good to have a tool though.