Prior authorization denials for outpatient vs. inpatient care

Denials for outpatient care claims jumped 16% in the last three years, while inpatient care claims rose 26%, according to a May 21 report from Kodiak Solutions. 

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Kodak, which monitors patient financial transactions from more than 1,850 hospitals and 250,000 physicians nationwide, analyzed claims denial rates over the last three years. 

Here’s a breakdown of prior authorization and precertification denial rates by inpatient and outpatient care from 2021 to 2023:

2023

Inpatient: 2.2%

Outpatient: 1.1%

2022

Inpatient: 2.1%

Outpatient: 1.1%

2021

Inpatient: 1.7%

Outpatient: 0.9%

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