Prior authorization denials for outpatient vs. inpatient care

Denials for outpatient care claims jumped 16% in the last three years, while inpatient care claims rose 26%, according to a May 21 report from Kodiak Solutions. 

Kodak, which monitors patient financial transactions from more than 1,850 hospitals and 250,000 physicians nationwide, analyzed claims denial rates over the last three years. 

Here's a breakdown of prior authorization and precertification denial rates by inpatient and outpatient care from 2021 to 2023:

2023

Inpatient: 2.2%

Outpatient: 1.1%

2022

Inpatient: 2.1%

Outpatient: 1.1%

2021

Inpatient: 1.7%

Outpatient: 0.9%

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