From Denial To Dollars

Payer denial of claims is a stubborn problem. Recent research found that employer-sponsored health plans denied 21% of claims. This is 20% for marketplace plans, 10% for Medicare, and 12% for Medicaid (see Health Insurance Denial Rates by Company).

These statistics are mirrored by provider organization executives who report that at least one in ten claims is denied.;But according to a recent survey—The Denial Problem (And Is AI The Answer?): 2025 State Of Claims—this is not only a health plan problem.;Half (50%) said that claims submitted had missing or inaccurate claim data. . . .