Practice Reporting. Prepared for Rowan Bexley on Oct 7, 2026. Whole organization.
November 2025 · prove it
Denial rate, practice total
8.06%Within toleranceReconciled with athena
What share of claims did each payer deny the first time?
How the number is made
Definition version 1, in force since Aug 3, 2025.
- Formula
- Claims a payer denied the first time it decided on them, divided by all claims a payer first decided on in the month. Resubmissions are not counted again.
- Claims denied the first time a payer decided on them
- 88
- Claims a payer first decided on in the month
- 1,092
- Result
- 8.06%
- Filters
- Primary payer only
- The payer’s first decision only
- Self pay left out (no payer decides on it)
- Scope
- Practice total
Checked against athena
The athena report to run, what it showed, and how far apart the two are.
- athena report
- athenaOne Denial Management report, first-pass view, grouped by primary payer
- athena’s figure
- 8.31%
- Difference (ours minus athena)
- -0.25 points
- Tolerance
- Up to 0.50 points either way
- Evidence
- Open the athena report athena-2025-11-denial-management (sample), sample report, opens in a new tab
- Checked
- Dec 4, 2025, 9:00 AM EST by Rowan Bexley
- Why they differ
- The same 3 resubmission denials from Statewide Care Program: athena’s practice-wide rate counts each one as another denied claim, and ours does not. Every other payer matches.Current explanation, written by Rowan Bexley, Dec 4, 2025, 10:00 AM EST
The run behind it
- Source
- Demo data
- Pulled from athena
- Dec 3, 2025, 5:00 AM EST
- Records counted
- 42,978 claims, 1,314 appointments
- Internal checks
- All 11 passed
For your IT team
Software version
rpt-pipeline 1.1.0.