Premier conducted a nationwide survey of hospitals, health systems and post-acute care providers, gathering data on their experiences with issues including medical claims, prior authorizations and claim-related delays in care delivery.
Here are four additional survey findings:
1. Of the claims sent to payers that are denied, an average of 3.2% were claims that had been pre-approved through prior authorization.
2. Among claims that had been denied, 54.3% of denial decisions were eventually overturned by payers.
3. The work to get initially denied claims overturned cost hospitals and health systems an average of $43.84 per claim.
4. Considering that payers process approximately 3 billion claims annually, hospitals and health systems spend about $19.7 billion every year pursuing claim reconsiderations.
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