Decoding Denials
The Fun and Efficient Way with OpenPM’s Denial Analysis Report
Updated June 22, 2026
Originally Published August 14, 2024
We all know that dealing with claim denials can feel like navigating a labyrinth without a map. But what if we told you there’s a secret weapon within OpenPM that not only simplifies this process but makes it deeply satisfying? Enter the Denial Analysis Report: your new best revenue cycle management friend. Let’s take a tour through this unDENIABLY fantastic feature!
All Aboard the CARC Management Bus!
Imagine you’re on a road trip, and the Claim Adjustment Reason Code (CARC) Management Library is your trusty bus driver. This library is at the heart of the Denial Analysis Report, packed with preloaded codes that explain exactly why a claim was denied (or accepted). Think of these codes as your road signs, guiding you smoothly through the complex terrain of resolving claim denials.
CARC Codes: Your Decoder Ring for Denials
Remember those decoder rings you used to get in cereal boxes? The CARC codes work similarly, giving you the power to decipher the reasons behind each claim denial. Each code on an Electronic Remittance Advice (ERA) comes with a clear explanation tailored to your practice. No more guesswork or deciphering cryptic payer language.
A Pre-Loaded Treasure Chest
The CARC Management Library in OpenPM is like finding a treasure chest that’s already full of treasure. You don’t have to spend countless hours building your denial management system from scratch. Instead, you get a preloaded framework that you can tweak and customize to fit your specific workflows and needs. It’s like starting a game at level 10!
In-Depth Denial Analysis: Dive In!
The Denial Analysis Report isn’t just a surface-level tool; it dives deep into the specifics of each denial. A whopping 84% of all claim denials are potentially avoidable with proper tracking. This report looks at CARC codes marked as denials in the practice management system and allows you to tag specific issues as “Preventable.” This helps your team focus on reducing pesky (and often repetitive) denials in the future. Plus, you can send encounters from the report to a worklist for further action, ensuring nothing slips through the cracks.
Reporting with Style
This report isn’t just detailed, it’s visually intuitive. Whether you want a broad executive overview or a line-by-line analysis, the Denial Analysis Report has got you covered. Filter your reports for Denials that are Posted, Not Posted, or Posted As Note. Compare them by the number of encounters, the percentage of denials, or the percentage of all items. It’s essentially a customizable dashboard for your denial data.
Save, Auto-Run, and Relax
Say goodbye to repetitive manual reporting, and wave hello to automation! With the ability to save filters and set your reports to auto-run with specific date spans, you can set it and forget it. Your reports will be ready and waiting for you on the My Reports screen, which is just a click away. It’s your own personal assistant for your denial management!
Top Denials: The Greatest Hits
Who doesn’t love a good “greatest hits” album? The Denial Analysis Report lets you see your top denials, sorted by CARC Code. Whether you want to tackle the top 5, 10, 25, 50, or even 100 denials, you can get as specific as you want.
Charge Management Rules: The Final Touch
To top it all off, take what you learn from the Denial Analysis Report, and incorporate adjustments to your charge management rules. Mike Kuhns, the head of our data analyst team, explains, “The Denial Analysis Report lets us find the problems; Charge Management is a way to fix them going forward.” It’s the final touch that ensures you’re actually preventing future denials, not just constantly resubmitting them.
Wrapping It Up
So there you have it, OpenPM’s Denial Analysis Report is not just a tool; it’s your reliable sidekick in the fight against lost revenue. With its preloaded library, detailed reporting, customizable options, and easy automation, it transforms a daunting task into a manageable (and maybe even enjoyable) process. Whether you’re a current user or considering joining the OpenPM family, this feature is designed to make your daily life easier and your organization more profitable. Happy denial decoding!
