Revenue cycle metrics
Denial rate
The percentage of submitted claims denied, ideally segmented by cause, payer and provider.
What it means in dermatology
An aggregate denial rate names nothing. Segmented by cause it points at a process; segmented by provider it points at documentation; segmented by payer it points at a policy change.
Dermatology practices should watch the modifier-25 and medical-necessity segments separately, since those two move for entirely different reasons.
Why it matters to your revenue
Every point of denial rate is roughly a week of staff time and a slice of revenue that never returns if the appeal window closes.
See this term in your own numbers
A free claims audit reviews a de-identified sample of your dermatology claims and returns a line-item findings report — including where terms like this one are costing you money.
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