ÌÇÐÄÆƽâ°æ

Health insurance claim denials in the U.S.

Statistic report on health insurance claim denials in the United States

This report provides some of the most important facts and figures concerning health claim denials in the United States. It presents information on ACA marketplace denials, denials of prior authorization, and denial appeals.

Download your Report

  We value your privacy and will never rent or sell your email address.

Privacy

Table of contents

Overview

7
  • Premium Statistic Top 5 medical insurance companies with the lowest claim denial rates in the U.S. 2023
  • Basic Statistic Major medical insurance companies with highest claim denial rates in the U.S. 2023
  • Premium Statistic Threshold for prevalence of medical claim denials in the U.S. 2023, by payer type
  • Premium Statistic Share of medical claims initially denied by payers in the U.S. 2023, by payer type
  • Premium Statistic Share of post-acute medical care claim denials in the U.S. 2023, by payer type
  • Premium Statistic Share of adults who experienced delay in care due to insurer denial in the U.S. 2023
  • Premium Statistic Share of U.S. adults with health insurance problems in past year 2023

ACA Marketplace denials

6
  • Premium Statistic Number of in-network claims denied by HealthCare.gov issuers in the U.S. 2023
  • Premium Statistic Share of in-network claims denied by HealthCare.gov issuers in the U.S. 2015-2023
  • Premium Statistic Average denial rates for in-network claims by ACA issuers in the U.S. 2023, by state
  • Premium Statistic Denial rates for major HealthCare.gov parent companies in the U.S. in 2023
  • Premium Statistic Average denial rates for in-network claims by ACA issuers U.S. 2023, by plan level
  • Basic Statistic Share of denial rates for in-network claims by ACA issuers U.S. 2023, by reason

Prior autherization

9
  • Premium Statistic Most common reasons why coverage is denied by medical insurers in the U.S. 2023
  • Premium Statistic Number of prior authorization determinations for MA plans in U.S. 2019-2023
  • Premium Statistic Prior authorization denial rates among Medicare Advantage firms in the U.S. in 2023
  • Premium Statistic Time taken to complete and number of PAs each week for U.S. physicians 2019-2023
  • Premium Statistic Care delays associated with prior authorizations according to U.S. physicians 2023
  • Premium Statistic Patient harm associated with prior authorizations according to U.S. physicians 2023
  • Premium Statistic Physician views on prior authorization burden by insurance plan in U.S. 2024
  • Premium Statistic Physician views on care delays due to prior authorization in the U.S. 2024
  • Premium Statistic Physician views on treatment abandonment due to prior authorization issues U.S. 2024

Denials appealed

3
  • Premium Statistic Share of adults who appealed insurer denial of services in the U.S. 2023, by outcome
  • Premium Statistic Reasons for adults not appealing insurer denial of services in the U.S. in 2023
  • Premium Statistic Share of adults who appealed insurer denial of services in the U.S. 2023
Report this content
FURTHER REPORTS

Recommended and recent reports

Recommended statistics

You may also be interested in...
We’re happy to help

Get in touch with us for additional information

Feel free to contact us anytime. We will respond to your inquiry as quickly as possible.

Get in touch