State of Claims 2026: An uphill battle to reduce denials

Denials have increased significantly since 2022, and new regulations could add even more pressure. To keep up, providers increasingly see technology upgrades as their best path forward. “Services not covered” is now the No. 1 reason for denials, while most providers recover only 50%-70% of revenue from denied claims. The survey also found that a significant majority of providers would replace their current revenue cycle technology if presented with a compelling return on investment. Most also plan to invest in artificial intelligence to help manage and prevent denials.

Key Findings:

• 40% of providers say 10% or more of claims are denied
• 53% of providers say “services not covered” is in their Top 3 reasons for denials
• Only 69% of providers say their organization manages denials quickly and efficiently – the lowest percentage since 2024
• 64% of providers definitely/probably will invest in AI for claims and denial

Reverse the uphill denial battle.

Download the full State of Claims 2026 report now to uncover actionable strategies and see the tactics providers are using to get ahead of denials.