Medical Billing Terms D: Denial Management, Deductible and Days in A/R
Denial management is the process of tracking, correcting and preventing denied claims. This page defines it with the other terms from data retention to duplicate claim, including denial rate, days in A/R, deductible and downcoding. Each entry gives a plain definition, why it matters, an example, and an official source. MCM South Medical Billing Service, LLC works only in mental and behavioral health billing.

On this page (25 terms)
- Data Retention
- Date of Service (DOS)
- Days in A/R
- Days in Unbilled
- DEA Registration
- Deductible
- Deemed Status
- Delegated Credentialing
- Denial Letter
- Denial Management
- Denial Prevention
- Denial Rate
- Dependent
- Dependent Coverage to Age 26
- Designated Record Set
- Diagnosis Pointer
- Diagnostic Evaluation (90791 / 90792)
- Digital Mental Health Treatment
- Distant Site
- Documentation
- Downcoding
- DSM-5-TR
- Dual Eligible
- Dual Eligible Special Needs Plan (D-SNP)
- Duplicate Claim
How to use these Denial Management definitions
Use this page as a quick reference for Denial Management, from Data Retention to Duplicate Claim. Each entry gives a plain definition, why it matters to a mental health practice, and an official source. When a rule changes by payer or state, the entry says so, so confirm Denial Management details with the payer before you bill.
Checklist: put the denial management definitions to work
- Check the denial management entries above before you send a claim that depends on them.
- Share this denial management page with front-desk and billing staff so everyone works from the same definitions.
Data Retention
Also called record retention; medical record retention
- Definition
- How long records must be kept, set by law, contracts, and payer rules, which vary.
- Why it matters
- Retention periods affect audits and disputes.
- Illustrative example
- A state sets a minimum retention period for records.
Related termsMedical Record AuditDocumentation
Reference sourceAHIMAchecked 10/9/26
CategoriesAudits & Compliance
Date of Service (DOS)
Also called DOS; service date
- Definition
- The date the billed service was delivered.
- Why it matters
- It drives timely filing, eligibility, authorization, and coverage checks.
- Illustrative example
- A claim for a session on the 3rd must be filed within the payer's timely filing window from that date.
Related termsTimely FilingCoverage Effective DateClaim
Reference sourceCMS (Centers for Medicare & Medicaid Services)checked 10/9/26
CategoriesClaims Processing
Days in A/R
Also called days in accounts receivable; DAR; A/R days
- Definition
- A metric estimating how many days of average daily revenue are tied up in accounts receivable.
- Why it matters
- A high number signals slow collections or denial problems.
- Illustrative example
- A practice with $60,000 in A/R and $2,000 in daily charges has 30 days in A/R.
Related termsAccounts Receivable (A/R)A/R AgingNet Collection Rate (NCR)
Reference sourceHFMAchecked 10/9/26
CategoriesRevenue Cycle Metrics
Days in Unbilled
Also called unbilled days; unbilled A/R
- Definition
- The number of days of revenue for services delivered but not yet billed.
- Why it matters
- Shows the backlog before claims are sent.
- Illustrative example
- A practice has unbilled sessions from the last 10 days.
Related termsCharge LagDays in A/R
Reference sourceHFMAchecked 10/9/26
CategoriesRevenue Cycle Metrics
DEA Registration
Also called DEA number; DEA license
- Definition
- A registration from the Drug Enforcement Administration that allows prescribers to prescribe controlled substances.
- Why it matters
- Payers and pharmacies verify it, and it is part of credentialing for prescribers.
- Illustrative example
- A psychiatrist's DEA registration is listed in the credentialing file.
Related termsEPCSCredentialing
Reference sourceHHS (U.S. Department of Health and Human Services)checked 10/9/26
CategoriesCredentialing & EnrollmentBehavioral Health Specific Terms
Deductible
Also called annual deductible; plan deductible
- Definition
- The amount a member pays for covered services before the plan starts paying, for services that are subject to the deductible.
- Why it matters
- Explains why early-year visits often have higher patient balances.
- Illustrative example
- A patient with a $1,500 deductible pays the allowed amount until it is met.
Related termsCopayCoinsuranceOut-of-Pocket MaximumPlan Year
Reference sourceCMS (Centers for Medicare & Medicaid Services)checked 10/9/26
CategoriesPatient Financial Responsibility TermsEligibility & Benefits
Deemed Status
Also called deemed status; deeming authority; CMS deemed accreditation
- Definition
- Deemed status is when CMS accepts accreditation from an approved accrediting organization as evidence that a provider meets Medicare conditions, in place of a state survey, for certain provider types.
- Why it matters
- It applies to certain provider types and programs, not to most independent behavioral health practices. Check whether your provider type is affected.
- Illustrative example
- A hospital's Joint Commission accreditation gives it deemed status for Medicare participation.
Related termsAccreditationThe Joint CommissionMedicareFederally Qualified Health Center (FQHC)
Reference sourceThe Joint CommissionCMS (Centers for Medicare & Medicaid Services)checked 10/9/26
CategoriesQuality & Risk Adjustment TermsMedicare & Medicaid Terms
Delegated Credentialing
Also called delegation agreement
- Definition
- An arrangement in which a payer lets another organization, such as a large group or IPA, perform credentialing on its behalf under agreed standards.
- Why it matters
- It can shorten enrollment for clinicians inside a delegated group, but it requires audits and oversight.
- Illustrative example
- A large group with a delegation agreement credentials its own clinicians for a payer.
Related termsCredentialingNCQAGroup Enrollment
Reference sourceNCQAchecked 10/9/26
CategoriesCredentialing & EnrollmentContracting & Network Management
Denial Letter
Also called adverse benefit determination; notice of denial
- Definition
- A written notice explaining a denial, including reasons, appeal rights, and deadlines.
- Why it matters
- The letter is the source for appeal deadlines and required documents.
- Illustrative example
- A biller logs the date and appeal deadline from each letter.
Related termsAppealAppeal DeadlineAdverse Benefit Determination
Reference sourceCMS (Centers for Medicare & Medicaid Services)U.S. Department of Labor, EBSAchecked 10/9/26
CategoriesDenials & Appeals
Denial Management
Also called denial workflow; denial follow-up
- Definition
- A process for tracking, categorizing, fixing, and preventing denials.
- Why it matters
- Good denial management raises first-pass resolution and cuts write-offs.
- Illustrative example
- A biller works denial reports weekly, by reason code and payer.
Related termsDenial RateRoot Cause AnalysisAppeal
Reference sourceHFMAchecked 10/9/26
CategoriesDenials & AppealsRevenue Cycle Metrics
Denial Prevention
Also called front-end denial prevention
- Definition
- Process steps that stop denials before they happen, such as eligibility checks, authorization tracking, and claim scrubbing.
- Why it matters
- Preventing denials costs less than appealing them.
- Illustrative example
- A practice adds a required eligibility check to intake.
Related termsDenial ManagementClaim ScrubbingEligibility Verification
Reference sourceHFMAchecked 10/9/26
CategoriesDenials & AppealsRevenue Cycle Metrics
Denial Rate
Also called claim denial rate; initial denial rate
- Definition
- The percentage of submitted claims that are denied, often measured by count or dollar amount.
- Why it matters
- Rising rates point to front-end or payer problems.
- Illustrative example
- A practice sees 8% of claims denied initially.
Related termsDenial ManagementRoot Cause AnalysisFirst Pass Resolution Rate (FPRR)
Reference sourceHFMAchecked 10/9/26
CategoriesRevenue Cycle MetricsDenials & Appeals
Dependent
Also called covered dependent; patient relationship
- Definition
- A person covered under another person's plan, such as a spouse or child.
- Why it matters
- Dependent info errors (birth date, relationship) reject claims.
- Illustrative example
- A child is covered under a parent's plan.
Related termsSubscriberMember ID
Reference sourceCMS (Centers for Medicare & Medicaid Services)checked 10/9/26
CategoriesEligibility & Benefits
Dependent Coverage to Age 26
Also called adult child coverage; young adult on parent's plan; ACA dependent coverage
- Definition
- Dependent coverage to age 26 is a federal Affordable Care Act rule that requires health plans that offer coverage for children to keep making it available to an adult child until age 26.
- Why it matters
- A young adult can be over the age of majority and still be a dependent on a parent's plan. The parent is the subscriber, the patient is the adult decision-maker, and statements can go to the wrong person. Verify the plan's rules, and use a confidential communications request when needed.
- Illustrative example
- A 22-year-old is a patient and a dependent on her father's plan. Her EOBs go to her father, so she asks to receive communications at her own address.
Related termsDependentSubscriberConfidential Communications RequestAge of Majority (Healthcare)
Reference sourceHHS (U.S. Department of Health and Human Services)checked 10/9/26
CategoriesEligibility & BenefitsPatient Financial Responsibility Terms
Designated Record Set
Also called DRS; designated record set HIPAA; medical and billing records
- Definition
- A designated record set is the group of records a covered entity keeps that are used to make decisions about an individual. It includes medical and billing records, and it defines what a patient can access or ask to amend under HIPAA.
- Why it matters
- Know what is in it before you answer a records request. Psychotherapy notes kept separately are not part of it.
- Illustrative example
- A practice decides that the chart, the intake forms, and the billing ledger are part of the designated record set, and keeps separate psychotherapy notes out of it.
Related termsRight of Access (HIPAA)Psychotherapy NotesProtected Health Information (PHI)HIPAA Privacy RuleGuide: HIPAA for billing
Reference sourceHHS (U.S. Department of Health and Human Services)HHS Office for Civil Rights (OCR)checked 10/9/26
CategoriesAudits & Compliance
Diagnosis Pointer
Also called dx pointer; diagnosis pointer letter
- Definition
- The field on a service line that links the procedure to one or more diagnoses on the claim.
- Why it matters
- A missing or wrong pointer can cause rejections or denials.
- Illustrative example
- Line 1 points to diagnosis A, the primary diagnosis.
Related termsPrimary DiagnosisICD-10-CMClaim Form
Reference sourceNUCCchecked 10/9/26
Diagnostic Evaluation (90791 / 90792)
Also called 90791; 90792; psychiatric diagnostic evaluation; intake evaluation
- Definition
- CPT codes for a psychiatric diagnostic evaluation: 90791 without medical services and 90792 with medical services, generally used by prescribers.
- Why it matters
- Determines the correct intake code for therapists versus psychiatrists.
- Illustrative example
- A therapist bills 90791 for an intake; a psychiatrist bills 90792.
Related termsCPT CodePsychotherapy Time RangesFrequency Limit
Reference sourceAmerican Medical Association (AMA)checked 10/9/26
Digital Mental Health Treatment
Also called DMHT; digital therapeutics
- Definition
- Use of software-based or digital tools as part of behavioral health treatment, with emerging billing codes in some programs.
- Why it matters
- Coverage is evolving and payer-specific.
- Illustrative example
- A payer covers a digital treatment device under a specific code.
Related termsTelehealthAI Scribe
Reference sourceCMS (Centers for Medicare & Medicaid Services)checked 10/9/26
Distant Site
Also called provider site; telehealth distant site
- Definition
- The location of the clinician furnishing a telehealth service.
- Why it matters
- Some payers require the clinician's location to be reported or restricted.
- Illustrative example
- A therapist provides sessions from a home office.
Related termsOriginating SiteTelehealth
Reference sourceCMS (Centers for Medicare & Medicaid Services)checked 10/9/26
Documentation
Also called clinical documentation; documentation requirements
- Definition
- The clinical record that shows what service was provided, when, for how long, and why, in support of the claim.
- Why it matters
- Good documentation is the best defense in audits and appeals.
- Illustrative example
- A note records date, start and end times, diagnosis, intervention, and plan.
Related termsProgress NoteMedical Record AuditMedical Necessity
Reference sourceAHIMAchecked 10/9/26
CategoriesAudits & ComplianceBehavioral Health Specific Terms
Downcoding
Also called payer downcoding; code downgrade
- Definition
- A payer's change of the billed code to a lower-paying code, often for time or level of service reasons.
- Why it matters
- Contracts may allow downcoding under policy; documentation is the main defense.
- Illustrative example
- A payer pays a 90834 rate for a claim billed as 90837.
Related termsPsychotherapy Time RangesDocumentationUnderpayment
Reference sourceCMS (Centers for Medicare & Medicaid Services)checked 10/9/26
CategoriesDenials & Appeals
DSM-5-TR
Also called DSM; Diagnostic and Statistical Manual of Mental Disorders
- Definition
- The American Psychiatric Association's manual for diagnosing mental disorders. Clinicians diagnose with the DSM, and claims carry the matching ICD-10-CM code.
- Why it matters
- Clinical diagnoses must be translatable to billable ICD-10-CM codes.
- Illustrative example
- A therapist documents a DSM-5-TR diagnosis and codes it on the claim in ICD-10-CM.
Related termsICD-10-CMMedical NecessityDiagnostic Evaluation (90791 / 90792)
Reference sourceAmerican Psychiatric Associationchecked 10/9/26
Dual Eligible
Also called dually eligible; Medicare-Medicaid enrollee; dual-eligible beneficiary
- Definition
- A person enrolled in both Medicare and Medicaid.
- Why it matters
- Billing sequence, payment limits, and crossover rules are specific to dual eligibles.
- Illustrative example
- A patient with Medicare and Medicaid receives therapy; Medicare pays first.
Related termsCrossover ClaimQualified Medicare Beneficiary (QMB)Medicaid
Reference sourceCMS (Centers for Medicare & Medicaid Services)Medicaid.govchecked 10/9/26
Dual Eligible Special Needs Plan (D-SNP)
Also called D-SNP; dual special needs plan; Medicare Medicaid dual plan
- Definition
- A dual eligible special needs plan is a Medicare Advantage plan for people who qualify for both Medicare and Medicaid. It coordinates benefits for those members.
- Why it matters
- Billing can involve Medicare, the plan, and the state Medicaid program. Check who pays what, and how the plan handles cost sharing that Medicaid covers.
- Illustrative example
- A patient with both Medicare and Medicaid enrolls in a D-SNP, so the biller checks how the plan handles cost sharing before billing.
Related termsDual EligibleSpecial Needs Plan (SNP)Crossover ClaimMedicaid
Reference sourceCMS (Centers for Medicare & Medicaid Services)Medicaid.govchecked 10/9/26
CategoriesMedicare & Medicaid TermsBCBS, UHC & Commercial Payer Terms
Duplicate Claim
Also called duplicate claim denial
- Definition
- A claim that repeats one the payer already has, often triggering a denial.
- Why it matters
- Resubmitting an unpaid claim without checking status is a common cause.
- Illustrative example
- A practice resubmits a claim still in process and receives a duplicate denial.
Related termsClaim StatusCorrected Claim
Reference sourceCMS (Centers for Medicare & Medicaid Services)checked 10/9/26
CategoriesClaims ProcessingDenials & Appeals
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Quick answer: Denial Management
What is denial management?
Denial Management is a process for tracking, categorizing, fixing, and preventing denials. Good denial management raises first-pass resolution and cuts write-offs.
Frequently asked questions: Denial Management
What are days in A/R?
Days in A/R is a metric estimating how many days of average daily revenue are tied up in accounts receivable. A high number signals slow collections or denial problems.
What is a deductible?
Deductible is the amount a member pays for covered services before the plan starts paying, for services that are subject to the deductible. Explains why early-year visits often have higher patient balances.
What is downcoding?
Downcoding is a payer's change of the billed code to a lower-paying code, often for time or level of service reasons. Contracts may allow downcoding under policy; documentation is the main defense.
Related resources
Where MCM South works
MCM South serves psychotherapists and psychiatrists in ten states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois.
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