Multi-Institutional Analysis of Insurance Denial Patterns Within Rhinology *

Tyler A. Janz, Najm S. Khan, Aatin K. Dhanda, Masayoshi Takashima, Arthur W. Wu, Dennis M. Tang, Thomas S. Higgins, Murugappan Ramanathan, Omar G. Ahmed

Research output: Contribution to journalArticlepeer-review


Background: Obtaining insurance approval is a necessary component of healthcare in the United States and denials of these claims have been estimated to result in a loss of 3% to 5% of revenue. Objective: Examine the trends in insurance denials for rhinological procedures. Methods: A retrospective review of deidentified financial data of patients who were treated by participating physicians across 3 institutions from January 1, 2021, to June 30, 2023. The data was queried for rhinological and non-rhinological procedures via CPT codes. Cumulative insurance denials were calculated and stratified by procedure and insurance type. Write-offs were dollar amounts associated with final denials. Results: A sample of 102,984 procedures and visits revealed a final denial rate between 2.2% and 2.9% across institutions (p =.72). The top three rhinological procedures for final write-offs were: nasal endoscopy (16.24%, $111,836.87), nasal debridement or polypectomy (6.48%, $79,457.51), and destruction of intranasal lesion (2.11%, $56,932.20). The write-off percentage for each procedure was highest among commercial insurance payers as opposed to Medicare or Medicaid. Conclusion: Final denial rates of rhinology procedures ranged between 2% and 3%. Common procedures such as nasal endoscopy and nasal debridement are among the highest written-off procedures. Insurance denials can lead to notable revenue loss. Rhinology practices must continue to remain knowledgeable of the changes and effects of insurance reimbursement on their practice.

Original languageEnglish (US)
Pages (from-to)218-222
Number of pages5
JournalAmerican Journal of Rhinology and Allergy
Issue number4
StatePublished - Jul 2024


  • allergy
  • endoscopy
  • health claims
  • immunology
  • insurance
  • insurance denial
  • practice management
  • prior authorization
  • revenue
  • rhinology

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology


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