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p.9

Increase in Non-Payment due to Errors

 According to a study of 1 million hospitals’ claims:1

 56% of claims contained coding errors

86% of the errors were HCPCS based

o

79% of the HCPCS errors were chargemaster related

 27% of claims contained billing errors

 17% of claims contained charging errors

 $75 to $125 per claim is the cost associated with managing a denial   

   or reworking a claim

1.

Healthcare Financial Management Association: Outpatient PPS Can Undermine Effective Revenue Cycle Management (July 30, 2004

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