Claims that came back and stayed back
Know why claims are denied, and which ones are worth chasing.
A denial is not lost revenue until somebody decides to stop working it. Without seeing denials grouped by cause, the ones that would have been paid on a second submission get written off alongside the ones that never had a chance. We group them by root cause and show where recovery effort is most likely to pay.
Denials last month, by root cause
Forty nine denials across four causes. Select one to see the claims behind it.
Office visit, established patient
Larkmoor Care. Plan terminated 9 days before the visit.
$610
Diagnostic imaging
Cardinal Mutual. No approval on file at submission.
$1,240
Minor procedure
Northbridge Health. Modifier missing on a paired service.
$845
Follow-up visit
Keystone Benefit. Coverage active under a different plan.
$385
Laboratory panel
Larkmoor Care. Filed 11 days past the window.
$296
Specialist consultation
Vantage Blue. Approval expired before the visit.
$720
Preventive visit
Cardinal Mutual. Service coded as diagnostic, not preventive.
$430
Office visit, new patient
Tessamer Health Plan. Deductible plan not yet effective.
$515
Showing 8 of 8 sample claims. Payer names are fictional.
Sample denials for one month, grouped by root cause. Select a cause to filter the claims beneath it.
Every denial, grouped by its cause.
Denials get grouped by what actually caused them, whether that is an eligibility problem, a missing authorization, a coding issue or a filing deadline that passed. That turns an undifferentiated pile into a small number of causes, most of which repeat.
Where rework is most likely to pay.
A clear read on where rework is most likely to be paid, and which causes keep coming back and are worth fixing at the front of the process. Denials that were quietly written off show up here too.
Every group opens to its claims.
Every grouping opens into the claims inside it, so a cause is never just a number on a chart. You can see the individual claims, what happened to each, and decide for yourself what is worth pursuing.
Works with the rest of Incura
The number at the bottom of the report
The audit
An independent check of a closed month that finds the dollars that never arrived, reconciled so the total ties to what actually hit your bank account.
Recoverable found, one month
Total recoverable
$27,400
Across 112 claims, charges and patient balances at a three-provider practice, September
A payer’s contract sets a rate for a procedure and the payment came in under it. Nothing about the claim was rejected, so nothing flagged it. It was posted, closed, and counted as collected.
33 claims
Which of your denials are still worth working?
It starts with one short call. We walk you through Incura and what it would show you about your own practice’s revenue. No cost, no commitment.
We usually reply within one business day.