Here's How Much We Paid With Medicare | Medicare Supplement vs Advantage

[Michael]

If anybody is interested in how often Medicare Advantage programs require prior authorization and how often they deny procedures, this article might be interesting:

https://www.kff.org/medicare/issue-brief...s-in-2021/

In 2021 there were 35 million prior authorizations filed and 94% were approved. Of those that were not approved, 11% were appealed. Of those appealed, 82% were ultimately approved. With that low a percentage appealed and that high a percentage ultimately approved, I'd bet that most appeals were related to not having the appropriate information in the initial prior authorization.

It is interesting to see how different the various insurance companies are in their requirements, approvals and reversals of denials.