Denials used to be treated as friction. They now look more like a structural margin threat. In 2025, 41% of providers said at least 10% of their claims were denied, up from 38% in 2024 and 30%
Denials used to be treated as friction. They now look more like a structural margin threat. In 2025, 41% of providers said at least 10% of their claims were denied, up from 38% in 2024 and 30%
You're probably staring at a queue of remits, patient statements waiting to go out, and aging balances that don't make sense. The payer says the claim processed. Your billing system says the encounter is still short. The
Your practice may be busier than ever and still feel financially weaker than it did a few years ago. Schedules are full. Providers are productive. The phones don't stop. Yet cash arrives late, denials keep stacking up,
You're probably dealing with one of these situations right now. A clean-looking claim went out. The diagnosis was right. The CPT or HCPCS line looked right. The documentation supported the service. Then the remittance came back denied,
Claims adjudication cost providers more than $25.7 billion in 2023, and nearly $18 billion of that may have been unnecessary because many disputed claims were ultimately paid after review, according to a major hospital survey reported by
A familiar scene plays out in specialty practices every day. Your team submits a clean claim for a service you perform constantly, the EOB comes back, and the payment is nowhere near the charge or what your
An out of network claim lands in your work queue. The case was legitimate, the documentation is solid, the coding is supportable, and the payer still sends a payment that bears little resemblance to the value of
$262 billion in healthcare claim denials each year is not a billing nuisance. It's a revenue control failure, and a large share is avoidable according to this denial management estimate. If you're treating denials as routine back-office
