Certain commercial health insurer policies and administrative practices delay patient care, overburden clinicians and withhold critical payments from providers.
Contributing to workforce burden:
- 95% of hospitals and health systems report increases in staff time spent seeking prior authorization approval.
- 84% report the cost of complying with insurer policies is increasing.
- 0% say it's decreasing.
And much of this effort and cost is unnecessary. 62% of prior authorization denials and 50% of initial claims denials that are appealed are ultimately overturned.
And it is only getting worse.
- 78% of hospitals and health systems report that their experience with commercial insurers is getting worse.
- Less than 1% said it’s getting better.