Last updated: October 31, 2026
What medical claim denials cost providers
Denial rates, write-offs, and revenue leakage from Kodiak revenue cycle data, MGMA polls, and hospital association figures.
A denied claim is not a lost claim, and that distinction is where the money goes. Most denied claims eventually get paid, after rework that costs staff time and delays cash by weeks. The 2026 data carries a twist worth noting: initial denial rates fell in the first half of the year, yet providers still leaked more revenue than the year before, because final denials rose and payers clawed back more payments after the fact. Fewer denials at the front door did not mean more money kept.
The figures
| Figure | Value | Trend vs prior period | Source |
|---|---|---|---|
| Initial claim denial rate, hospitals and physicians (Kodiak) | 11.81% of claims in 2024 (2,100+ hospitals, 300,000+ physicians) | ● Annual series (see note) Annual 2024 figure; not part of the half-year series below (12.00% in H1 2025 → 10.63% in H1 2026, Kodiak half-year series, reported by TechTarget) | Kodiak Solutions revenue cycle data (reported by Practice Fusion) |
| Initial claim denial rate, half-year comparison (Kodiak) | 10.63% in H1 2026 | ▼ Down Prior: 12.00% in H1 2025 | Kodiak Solutions revenue cycle data (reported by TechTarget) |
| Final denial write-offs as share of net revenue | 3.07% in H1 2026 | ▼ Down Prior: 3.31% in H1 2025 | Kodiak Solutions revenue cycle data (reported by TechTarget) |
| Median final denial rate | 2.7% (2025) | ▲ Up Prior: 2.5% in 2024 | Kodiak Solutions State of the Healthcare Revenue Cycle (reported by Flobotics) |
| Net revenue lost to final denials and uncollected balances | More than $48 billion (2025) | ▲ Up Prior: $38.6 billion in 2024 — a 25% jump in one year | Kodiak Solutions State of the Healthcare Revenue Cycle (reported by Flobotics) |
| Medical group leaders saying denial rates rose vs prior year | 60% (March 2024 MGMA Stat poll); only 11% said denials fell | ● Baseline Prior: Poll result for 2024 — no prior-year poll percentage in the cited reporting | Medical Group Management Association Stat poll (reported by Medical Economics) |
| Denials and appeals as the top revenue-cycle leak | 48% of group leaders (January 2026 MGMA poll); front-end issues second at 23% | ● Baseline Prior: January 2021 poll gave the same 48% figure for denials and appeals — flat across five years on this measure | Medical Group Management Association Stat poll (reported by Medical Economics) |
| First-submission denial average, medical groups | 7–8% averaged over the last four years; achievable target under 5% | ● Baseline Prior: MGMA-reported average — no single prior-year figure in the cited reporting | Medical Group Management Association (reported by Human Medical Billing) |
| Initial denial rate by payer type (AHA data) | Medicare Advantage 15.7%; commercial insurers 13.9% | ● Baseline Prior: Cross-sectional payer comparison — no prior-period figure in the cited reporting | American Hospital Association data (reported by Practice Fusion) |
How to read these numbers
Included: Kodiak Solutions revenue cycle data covering 2,100+ hospitals, MGMA Stat polls of medical group leaders, and American Hospital Association payer figures as reported in trade coverage. Excluded: Change Healthcare's own denial statistics, which could not be verified from a public primary source this session, and vendor marketing claims presented without a sample size. Kodiak figures reach this page through trade reporting of Kodiak's releases, and are labeled as such.
Disclaimer: Initial denial rates count claims denied on first submission, many of which are later paid; final denial rates count what is ultimately written off. The two must not be added together or compared as if they measured the same thing. Figures on this page are aggregated public estimates assembled for information only. They are not investment advice, legal advice, medical advice, or a professional opinion on any specific case, claim, project, or bottle. Original reporting and the underlying surveys remain the work of the sources linked above; this page summarizes their published figures with attribution and adds no proprietary dataset.
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Changelog
- October 2026: Initial edition — Kodiak denial-rate series 2024–2026, MGMA poll findings, payer-type denial rates, and revenue-leakage estimates established.
- October 31, 2026: First row relabeled so the annual 2024 figure is not read as part of the half-year series. No figure changed.