Insurance Claims: A Study in Denials

Abstract

The study was to analyze the insurance claim denials to determine if Baptist Health System (BHS) of San Antonio, TX was increasing (declining) or decreasing (improving) their denial rates. The data were obtained from the BHS's financial systems program. The model tested to be statistically significant using the Total Denial ANOVA table. The NULL hypothesis will be rejected and the ALTERNATE hypothesis will be accepted. F=4.7 (4,115)p=.001. The BHS has decreased their Overall denial rates by approximately 50% over the last 12 months (April 2006 to March 2007) from the previous 12 months (April 2005 to March 2006). BHS also shows a positive downward trend in all the sub-study groups: facilities, denial categories and patient categories.

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Document Details

Document Type
Technical Report
Publication Date
Nov 17, 2009
Accession Number
ADA516635

Entities

People

  • Ronald T. Goding

Organizations

  • Baptist Health System

Tags

Communities of Interest

  • Biomedical

DTIC Thesaurus Topics

  • Analysis Of Variance
  • Business Administration
  • Databases
  • Finance
  • Financial Management
  • Health
  • Health Care
  • Health Services
  • Information Science
  • Insurance
  • Medical Personnel
  • Normal Distribution
  • Personnel Management
  • Spreadsheet Software
  • Standards
  • Statistical Analysis
  • Therapy

Readers

  • Medical or Health Care Field.
  • Regression Analysis.
  • Strategic Security Studies