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Insurers Denied Over 12% of Prior Authorizations in Government Health Plans

By PulseAugur Editorial · [1 sources] ·

A recent analysis by the Kaiser Family Foundation (KFF) reveals that health insurers denied a significant portion of prior authorization requests for treatments and procedures across Medicare Advantage, Medicaid, and ACA Marketplace plans. Insurers denied between 12% and 18% of standard requests last year, with denial rates varying by insurer and plan type. The report highlights that a substantial percentage of these denials are overturned upon appeal, suggesting potential issues with the initial review process. AI

RANK_REASON Report on high denial rates for government-subsidized health insurance plans. [lever_c_demoted from significant: ic=1 ai=0.0]

Read on Forbes — Innovation →

AI-generated summary · Google Gemini · from 1 sources. How we write summaries →

Insurers Denied Over 12% of Prior Authorizations in Government Health Plans

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Report on high denial rates for government-subsidized health insurance plans. [lever_c_demoted from significant: ic=1 ai=0.0]
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COVERAGE [1]

  1. Forbes — Innovation TIER_1 English(EN) · Bruce Japsen, Senior Contributor ·

    Insurer Denials High In Medicare Advantage, Medicaid And Obamacare, Report Says

    Health insurers denied “at least 1 in 8 standard requests” when prior authorization was required across Medicare Advantage, Medicaid and Obamacare last year, KFF said.

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