Percentage of Claims Initially Denied, by Payer Type

  1. Medicaid: 16.7%
  2. Medicare Advantage: 15.7%
  3. Managed Medicaid: 15.1%
  4. Commercial: 13.9%
  5. Medicare: 8.4%
Notes: Note: An average of 3.2% of all claims denied included those that were pre-approved via the prior authorization process.

Source: Premier, Trend Alert: Private Payers Retain Profits by Refusing or Delaying Legitimate Medical Claims, March 2024 - https://premierinc.com/newsroom/blog/trend-alert-private-payers-retain-profits-…

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