Twenty denials. Five columns. No names.
This is the whole free review. One row per denied claim, twenty rows, and you email it back. Nothing on it identifies a patient, so nothing needs signing first.
| Payer | Procedure code | Denial reason code | Billed amount | Age of denial |
|---|---|---|---|---|
| CareFirst | 97110 | CO-197, no authorization | $168 | 30 to 90 days |
| Aetna | 90837 | CO-29, timely filing | $210 | 90 to 180 days |
| Maryland Medicaid | 97140 | CO-4, modifier | $92 | Under 30 days |
Three example rows, fictional. Or make your own sheet with these five headings. The format does not matter. The columns do.
Every column is on the remittance.
Nothing here needs a chart open. Your remittance advice, or your billing system's denial report, has all five.
Payer
Who denied it. The plan name as it appears on the remittance: CareFirst, Aetna, Maryland Medicaid.
Procedure code
The CPT or HCPCS code that was billed. 97110, 90837, 97140.
Denial reason code
The CARC and RARC from the remittance, or the payer's reason in a few words. CO-197, CO-29, no authorization, timely filing.
Billed amount
What you billed for the line, in dollars.
Age of denial
Under 30 days, 30 to 90, 90 to 180, or over 180. A bucket, not a date.
A date of service is patient information.
The age bucket does the same job without it. That is the reason the review can run on email, with no agreement signed and nothing to lock down. If a column asks for something below, leave it out.
- Patient names
- Dates of birth
- Dates of service
- Member or subscriber numbers
- Claim numbers
- Account numbers
- Anything from a chart
One page. Sorted by deadline, not by dollars.
- What is still winnable now
- What is winnable after a records pull
- What is already gone past its deadline, and why
- A dollar total for the first two
The report is yours whether or not you continue. If you do continue into recovery work, the business associate agreement and the secure intake channel come then, before any patient information moves.
Fill the twenty rows. Email it back.
Send the sheet to hello@frimpomaasync.com with your practice name in the subject. If you have not filled the two-minute fit form yet, do that first, so the reply can be about your denials and not denials in general.