This study examined the hospital billed charges and denials received for a Northern California Non-Profit Community Hospital and their trauma care patients seen between August 1, 2009, and December 31, 2009. The target of the thesis was to conduct an analysis on the billed charges, reimbursements, and denials from two data extracts provided by the organization in an effort to analyze its paid-to-billed ratios and denial trends in an effort to identify opportunities to increase their revenue.
A total of 707 patients received trauma care. All reimbursements and denials received by April 30, 2010, were included in the analysis. The paid-to-billed ratio was 12% for all hospital accounts and for the non-capitated accounts was 17%. A total of 101 claim denials with 403 specific denial reason codes were received. Fifteen percent of the total hospital bills received denials. The implications of these results were discussed.
|School:||California State University, Long Beach|
|School Location:||United States -- California|
|Source:||MAI 49/04M, Masters Abstracts International|
|Subjects:||Health care management|
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