## Executive Summary **Provider 3210** has a 100% denial rate on 8 encounters this month, generating zero revenue despite significant activity. All denials stem from Health Net CO-27 (patient eligibility) claims totaling $2,396. This pattern indicates either a credentialing lapse with Health Net or systematic eligibility verification failures at intake. With $1,198 recoverable in the next 60 days (all from appealable denials within timely filing), fixing this issue is urgent. Overall MTD denial rate stands at 67%, suppressing net collections to just 29% and driving Days in AR to 52. Provider 2109 is performing normally with 4 encounters, $980 PPS revenue, and 0% denials. **Immediate action:** Verify Provider 3210's Health Net credentialing status and enrollment; if valid, implement pre-visit eligibility checks for all Health Net members to prevent CO-27 denials at the front end.
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grounded in your data · no PHI sentTop denial reasons
claim count · MoM change- CO-27Coverage terminated / member not enrolled on DOS2—
Provider productivity
encounters � revenue � denial rate- Provider 2109NPI 87654321094$9800%
- Provider 3210NPI 98765432108$0100%