Becker's Healthcare May 24, 2024
Andrew Cass

Kodiak Solutions said in a May 21 report that if payers used consistent criteria for making prior authorization/preficiation claim denials, the denial rates would be similar across all payer categories.

“That would make it easier for providers to learn from those denials, reduce their overall initial denial rates and spend fewer resources appealing prior auth/precert denials because of conflicting and ever-changing payment criteria,” the report said

Kodiak analyzed prior authorization inpatient claims denials over the past three years and found rates varied by payer category. The company’s revenue cycle analytics software monitors patient financial transactions from more than 1,850 hospitals and 250,000 physicians nationwide.

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Topics: Health System / Hospital, Insurance, Payer, Provider, Survey / Study, Trends
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