Revenue Leaders Challenged Denial Rate Metrics

Healthcare executives argued at a recent conference that traditional denial rates no longer accurately reflect reimbursement.

Updated on Sept. 19, 2026 in Healthcare

Isometric editorial illustration of a brass archival cabinet spilling geometric currency shapes, representing healthcare financial reimbursement systems. — Revenue cycle leaders at the recent Health IT conference suggested that traditional hospital denial rates are outdated and require more complex metrics to reflect financial performance. AI Illustration. Upload story photo >

Live Poll

Should healthcare systems pursue every billing denial regardless of the claim's dollar value?

Revenue cycle leaders at the 11th Annual Health IT + Digital Health + RCM Conference have advocated for moving away from using denial rates as a standalone performance metric. The panelists emphasized that these figures fail to capture the nuances of hospital reimbursement complexity.

Why it matters

Traditional metrics often obscure the broader financial impact of low-dollar denials that accumulate within healthcare systems. By shifting focus, organizations aim to better align their internal processes with modern financial realities.

Organizations typically estimate the cost to process a single denial at $25. While low-dollar denials are often overlooked, their cumulative financial impact remains a significant concern for health systems.

The players

Stanford Health Care

This is a major academic healthcare system based in Palo Alto, California, known for its focus on medical research and clinical care.

NCH Healthcare System

Based in Naples, Florida, this organization operates as a primary healthcare provider for the local region.

PDS Health

This healthcare organization is headquartered in Henderson, Nevada, and focuses on dental and medical support services.

The details

Revenue cycle teams are increasingly turning to AI to automate responses to documentation requests, which helps lower the operational costs of pursuing denials. Panelists from Stanford Health Care, NCH Healthcare System, and PDS Health stressed that teams must iteratively analyze current workflows before integrating these new technologies.

September 18, 2026: Revenue cycle leaders discussed industry metrics at the 11th Annual Health IT + Digital Health + RCM Conference.

Market Landscape

The push to move beyond simple denial rates signals a significant shift in how hospitals manage fiscal efficiency compared to the historical reliance on denial rates as a primary revenue cycle performance indicator. This transition reflects an ongoing industry effort to prioritize comprehensive reimbursement capture over simplified performance reporting.

Patients may eventually see fewer administrative delays in their care as hospitals refine their documentation and reimbursement processes. More efficient billing operations can lead to more stable resource allocation within the healthcare systems that serve local communities.

The takeaway

Healthcare systems are increasingly leveraging AI to reduce administrative overhead associated with billing errors. Leaders suggest that hospitals should prioritize internal workflow improvements to ensure sustainable financial performance.