Finance/EOP / Denials

EOP / Denials

Total EOPs Processed

3,842

Total Denied

312

Denial Rate

8.1%

Total Denial Amount

$78,400

Top Denial Reason

Auth Required (28%)

Denial Breakdown by Reason

PracticeClaim #PatientPayorCPTChargePaidRemainingCodeReasonDenial Amt
LAECCLM-30412Garcia, R.EyeMed92014$325$0$325CO-197Auth Required$325
ECHCLM-40198Kahale, L.HMSA92004$250$180$70PR-1Patient Deductible$70
AECCLM-10287Smith, J.VSPV2020$185$0$185CO-29Timely Filing$185
SVEPCLM-50312Chang, L.Aetna92014$350$0$350CO-197Auth Required$350
VEOCLM-20445Tran, A.EyeMed92004$260$0$260CO-16Missing Modifier$260
EKOCLM-60289Davis, R.CignaV2781$340$0$340CO-18Duplicate Claim$340
LAECCLM-30534Reyes, C.Medicare92014$320$200$120CO-4Coding Mismatch$120
AECCLM-10345Wilson, E.EyeMedV2020$185$0$185CO-197Auth Required$185
ECHCLM-40312Santos, M.HMSA92004$255$0$255CO-29Timely Filing$255
VEOCLM-20567Park, J.UnitedV2783$420$280$140CO-27Patient Ineligible$140
SVEPCLM-50489Gupta, P.VSP92004$250$0$250CO-16Missing Modifier$250
EKOCLM-60345Martinez, A.EyeMed92004$245$0$245CO-4Coding Mismatch$245
LAECCLM-30612Brooks, A.United92014$350$0$350CO-197Auth Required$350
AECCLM-10412Taylor, S.CignaV2020$195$0$195CO-29Timely Filing$195
ECHCLM-40389Kim, D.VSPV2781$290$150$140CO-27Patient Ineligible$140