CYBHI Myth Buster: Denied Claims

Tackling the myths and realities behind CYBHI claim denials and how TadHealth helps you avoid them.

There’s a common misconception that most CYBHI claims simply get denied. While it’s true that denials happen, around 30% of filed claims, the real story lies in why they happen and how easily most can be prevented.

The Top Reasons for CYBHI Claim Denials - and How to Prevent Them

According to the California Department of Health Care Services, a majority (60%) of denied CYBHI claims are missing the provider NPI (National Provider Identifier), a critical but often overlooked requirement. Without it, claims can’t be validated for reimbursement. Other frequent issues include missing modifier codes (like the required U4) and invalid or unregistered service locations, both of which can cause claims to be rejected even when the service itself was eligible.

At TadHealth, we knew these details would be key to getting CYBHI reimbursement right. That’s why we:

Work directly with your district to ensure all NPIs are registered and verified.
Automatically apply the correct code modifiers (like U4) to each claim.
Validate service locations before submission to avoid mismatches.

The TadHealth Difference

Our platform was built to prevent common pitfalls before they happen. In fact, 78% of the top denial reasons are issues TadHealth automatically catches and resolves for you.

Here’s what the data from California’s Department of Health Care Services illustrates:

Of 14,000 denied claims statewide, 5,000 were corrected, resubmitted, and reimbursed.
64% were denied for missing or invalid NPIs.
3% were denied for missing U4 modifier codes (required for all CYBHI claims).
11% were tied to invalid or missing service locations.

TadHealth catches the most common claim submission mistakes (and more) before they ever reach the payer. The result? More reimbursements, fewer denials, and less time spent fixing errors. Claims billed through TadHealth have received a rejection rate of less than 1%.

Turning Denials into Dollars

With TadHealth, districts are turning denied claims into real reimbursements without adding extra work for staff. Our claim validation engine, automatic code mapping, and dedicated support team make it easy to submit clean, compliant claims every time.

Bottom line: CYBHI claim denials aren’t inevitable; they’re preventable. TadHealth helps you get it right the first time so your teams can focus on students, not paperwork.

Click here to learn more about how TadHealth helps districts simplify CYBHI claim submission and maximize reimbursements.