Claim Denials Rise as Providers Seek AI Fixes
A 2026 Experian Health survey of billing professionals finds denials climbing and most providers naming their reduction a top priority.
Updated on Nov. 6, 2026 in Healthcare
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Experian Health's 2026 State of Claims survey of 204 healthcare billing and claims professionals finds 75% say claim denials are increasing. Most respondents report payer policies changing more often and reimbursement harder to secure than a year ago.
Why it matters
Each denied claim forces provider teams to investigate, correct and resubmit, adding administrative cost and delaying payment. With 84% of respondents seeing potential in AI for claims management, the findings point to technology as a likely response to persistent denial pressure.
The survey of 204 respondents found 40% report at least 10% of claims denied, figures largely unchanged from last year. Services not covered was the leading cited reason for denials, followed by frequently changing payer policies.
The players
Experian Health
Experian Health is the healthcare division of the global information services company Experian, which provides data and analytics for revenue cycle management.
The details
Experian Health surveyed healthcare professionals responsible for billing and claims management. Respondents named services not covered as the top denial cause, with frequent payer policy changes second, and 64% said they plan to invest in AI for claims and denial management.
Timeline
2022: baseline year for payer policy change comparison.
2025: comparison year for denial rates and reimbursement difficulty.
2026: survey conducted, with 89% of providers naming denial reduction a priority.
Market Landscape
Experian Health's State of Claims survey series has tracked denial trends across successive years, and the 2026 results show denial rates holding at elevated levels rather than improving. The persistence of payer policy changes since 2022 suggests administrative friction in claims processing is a structural feature of the sector.
Patients may face delayed or unexpected bills when claims are denied and resubmitted. Providers' administrative workload rising from denials can affect staffing and the speed of billing resolution.
The takeaway
Denial management is becoming a core operational priority for providers, and the survey suggests AI tools are the leading expected response. Tracking how payer policy changes affect claim approval rates may help providers anticipate denials before submission.
Further reading
For broader context on the industry, see Healthcare coverage.
Source note: This article includes information reported by MedCity News.
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