KFF September 29, 2023
Karen Pollitz, Kaye Pestaina, Lunna Lopes, Rayna Wallace, Justin Lo

Introduction

A KFF survey of adults with health insurance found that roughly 6 in 10 insured adults experience problems when they use their insurance. Problems examined include denied claims, network adequacy issues, preauthorization delays and denials, and others. This Data Note takes a closer look at insured adults who said that in the past year, their health insurance denied or delayed prior approval for a treatment, service, visit or drug before they received it, which we will refer to as “prior authorization” problems. A separate Data Note looks at survey findings specific to the denial of health insurance claims.

Characteristics of consumers who experience prior authorization problems

The survey found that 16% of all insured adults in the past year...

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