Healthcare organizations now spend 50 to 75 hours a week managing insurance denials, according to Adonis's 2026 State of Revenue Cycle Management Report. That figure comes from a survey of more than 120 revenue cycle leaders across physician groups, management service organizations, health systems, and digital health operations, and it puts a number on where a practice's administrative week actually goes.
Denial volume is up, the hours needed to fight it are up, and most practices still have not closed the gap between what they want from automation and what they have actually installed.
Where the hours actually go
Nearly two-thirds of the leaders Adonis surveyed named denials and underpayments as the single largest barrier to revenue growth in 2026, ahead of staffing shortages and other operational inefficiencies that used to top that list. More than one-third said denial impact is now a standing topic at the executive level rather than a back-office metric buried in a monthly report. Adonis estimates that manual, traditional revenue cycle processes cost providers up to 15% or more of their potential revenue, which is the dollar version of the same 50-to-75-hour weekly time sink. Sixty-six percent of respondents called automated denial follow-up and resolution a very important AI capability for their 2026 revenue cycle strategy. Most leaders surveyed want the hours cut through technology, not through more hires.
Why the pile keeps growing
Experian Health's 3rd Annual State of Claims Survey, published September 22, 2025 from a sample of 250 healthcare professionals responsible for financial, billing, or claims decisions, found that 41% of providers now face denial rates of 10% or higher. Forty-three percent describe their own department as understaffed for the volume of claims work in front of them. Even so, 90% of denials still get at least some human review before resubmission, and 82% call reducing denials a priority for the year ahead. The root causes barely moved year over year: missing or inaccurate data drove 50% of denials, up from 46% in 2024; authorization problems held roughly steady at 35%, down from 36%; and incomplete or inaccurate patient registration data caused 32%, up from 30%.
The technology gap behind the hours
The same Experian survey found that 67% of respondents believe AI can improve the claims process, and 62% describe themselves as well-versed in AI, automation, and machine learning, up sharply from 28% in 2024. Actual use has not caught up with that confidence: only 14% report they are using AI in claims management today. Among that smaller group, 69% say it has already reduced denials or increased resubmission success. Forty-one percent of providers upgraded their claims management technology in the past year, yet only 56% believe their current technology is sufficient, down from 77% in 2022. Confidence in AI outpaces its actual use, and the 50-to-75-hour weekly figure sits in that gap.
What revenue cycle leaders are prioritizing instead
Black Book Research's 2026 Hospital RCM Evaluation, based on more than 1,300 provider-side respondents and released June 8, 2026, points to where the response is headed. Seventy-four percent of qualified respondents now prioritize denial prevention over post-denial recovery, a shift from chasing dollars after a denial to stopping the claim from being denied at all. Seventy-eight percent rank payer friction as a top-three technology stressor, and 76% link front-end data quality directly to denials or cash-timing problems, which matches Experian's finding that bad data drives half of all denials. Seventy percent of Black Book respondents want to reduce the number of RCM vendors they manage. Sixty-six percent say current analytics cannot support CFO-level revenue predictability, and 63% now consider AI auditability and explainability mandatory rather than optional.
| Finding | Figure | Source |
|---|---|---|
| Weekly hours spent on denial management | 50-75 hours | Adonis, 2026 State of Revenue Cycle Management Report |
| Leaders naming denials as the top barrier to revenue growth | ~66% (nearly two-thirds) | Adonis, 2026 |
| Providers facing denial rates of 10% or higher | 41% | Experian Health, 3rd Annual State of Claims Survey, Sept. 2025 |
| Denials caused by missing or inaccurate data | 50%, up from 46% in 2024 | Experian Health, 2025 |
| Providers actually using AI in claims management | 14% | Experian Health, 2025 |
| RCM leaders prioritizing denial prevention over recovery | 74% | Black Book Research, 2026 Hospital RCM Evaluation |
| RCM leaders ranking payer friction a top-3 stressor | 78% | Black Book Research, 2026 |
What this means for independent practices
Hospitals and large systems can point a dedicated denials team at the 50-to-75-hour figure Adonis measured. Independent practices usually cannot. The same hours tend to fall on the one or two staff members who also handle scheduling, coding, and patient calls, which is why the 41% of providers facing double-digit denial rates and the 43% who call themselves understaffed, both from Experian's survey, describe a smaller practice's week more than a hospital's. Seventy-four percent of Black Book's respondents now build their process around prevention rather than appeals, and 76% treat clean front-end data entry as a revenue function rather than a clerical one. For a practice with no denials department to point at anything, the front-end fix is the one it can copy without hiring first.
Sources
- PR Newswire, "Adonis 2026 Revenue Cycle Management Report: Payer Denials and Reimbursement Pressure Now the Top Drivers of Healthcare Revenue Risk," Feb. 19, 2026
- Experian plc, "Experian Health's 3rd Annual State of Claims Survey Finds Denials Still on the Rise Amid Escalating Challenges," Sept. 22, 2025
- RevCycleAI, "Black Book's 49-Category RCM Rankings Are Out - Here's What the Data Actually Tells You (2026)," 2026
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