Palmetto GBA has released the top denial reasons for pre-payment review of Texas hospitals from April to June, noting 44 claims were denied in that period.
 
Nearly a third of the total denials, 31%, were due to the documentation not supporting a prognosis that the patient had six months to live.
 
The rest of the top four were:
 
16% — No plan of care
12% — Face-to-face encounter requirements not met
10% — Physician narrative statement not present or not valid
8% — No certification for dates billed