Kodiak Solutions: Prior Authorization and Precertification Inpatient Claim Denial Rates in 2023

  1. Medicaid/managed care: 4.17%
  2. Medicaid/traditional: 3/16%
  3. Medicare/managed care: 2.69%
  4. Commercial/all managed care: 2.25%
  5. Medicare/traditional: 0.16%
Notes: Based on claims data from the Kodiak Revenue Cycle Analytics (RCA) platform used by more than 1,850 hospitals and 250,000 physicians.

Source: "Necessity is the mother of claim denials," Kodiak Solutions, May 2024 - https://static1.squarespace.com/static/65d790c56a64c0761fd9171e/t/664cbb48a8b64…