Fifty-four percent of denials from private payers that were initially denied were ultimately overturned and paid, "but only after multiple, costly rounds of provider appeals," according to a March 21 report from healthcare solutions company Premier.
Premier conducted a survey of hospital and health system leaders representing 516 hospitals across 36 states between Oct. 10 and Dec. 31, 2023. The respondents were asked to consider all claims from Jan. 1 to Dec. 31, 2022.
Here is the percentage of initial denials overturned, by payer type, according to the report:
Commercial: 60.5%
Medicare Advantage: 52.7%
Managed Medicaid: 49.7%
Medicare: 50%
Medicaid: 45.8%