BI Tools - Rejection Analysis

drchrono built this tool to help better understand and compare the clean claims percentage for each month for the last 12 month, and also helps you to understand the Rejection trend.

 The Clean Claims percentage is calculated through the formula:

(# of submissions - # of rejections) / (# of submissions)

 

When you select the 'Display Unworked Claims Only' checkbox, this formula changes to:

(# of submissions - # of unworked rejections) / (# of submissions)

An unworked rejection is a rejection that has not yet had work done on it to resolve the rejection. If all your rejections have been worked on, this percentage will calculate to 100%.

 

In the Details Tab, you can view all the rejections you have received from the clearing house & from the payer, and also using the "Group by" option you can group the rejection by Reason, Insurance and the code to identify the Rejection trend. 

 

 

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