State of Claims 2025 — Insights on rising denials & AI integration
Denials remain on the rise as errors become harder to catch early and eligibility rechecks take longer. This 2025 State of Claims report — based on a survey of healthcare finance and revenue cycle professionals — identifies what is driving denials and what actions health systems are taking to protect revenue.
The findings confirm a widening data quality gap. Registration inaccuracies, missing claim details and code errors continue to top denial lists. Operationally, rechecks that take 10-plus minutes are up, multi-system intake is the norm and 90% of denials still require at least some human review. Meanwhile, confidence in current tech is slipping, creating urgency for upgrades that actually move denial rates.
This report shows how organizations are prioritizing data accuracy, where they are streamlining intake and verification, what they are upgrading or replacing and how early AI pilots are performing. Use these benchmarks to align your roadmap, quantify gains and move quickly on the highest-yield fixes.
Learnings include:
The findings confirm a widening data quality gap. Registration inaccuracies, missing claim details and code errors continue to top denial lists. Operationally, rechecks that take 10-plus minutes are up, multi-system intake is the norm and 90% of denials still require at least some human review. Meanwhile, confidence in current tech is slipping, creating urgency for upgrades that actually move denial rates.
This report shows how organizations are prioritizing data accuracy, where they are streamlining intake and verification, what they are upgrading or replacing and how early AI pilots are performing. Use these benchmarks to align your roadmap, quantify gains and move quickly on the highest-yield fixes.
Learnings include:
- Where accuracy breaks down at registration, coding and authorizations — and how leaders are addressing it
- Insights on time and labor costs associated with rechecks and denials
- Why AI for claims management has low adoption despite powerful results
Please fill out the form to download the whitepaper.
