Becker's Healthcare December 30, 2025
Underpayment analysis and intelligent claims aging workflow management have become essential investments for healthcare organizations facing mounting revenue pressure.
With Medicare and Medicaid underpayments reaching $130 billion in 2022 and claim denial rates climbing to nearly 12% across the industry, health systems that deploy AI-powered detection and prioritization tools are recovering tens of millions in previously lost revenue—while those that don’t are leaving substantial money on the table.
The financial stakes are staggering. According to the American Hospital Association, Medicare now pays hospitals just 82 cents for every dollar spent on patient care—a record low that resulted in two-thirds of hospitals posting negative Medicare margins in 2022.
Commercial payers aren’t much better. The American Medical Association reports a 19.3% claims-processing...
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