Industry
Survey: Uncovered Services Now Top Reason for Claim Denials
Experian Health's 2026 "State of Claims" report, based on an August survey of 204 healthcare finance and billing professionals, finds 40% of providers report denial rates of 10% or higher, roughly flat from 41% in 2025 but up sharply from 31% in 2022. For the first time, "services not covered" ranked as the top denial reason, cited by 53% of respondents, ahead of frequently changing payer policies (31%) and code inaccuracy or prior authorization difficulty (25%). Most respondents said payer reimbursement is growing more challenging and payer policy changes more frequent, while 89% named denial reduction a 2026 priority, up from 76% in 2022. The report does not break out findings by payer type, including Medicaid.
Why it mattersRising denial rates tied to coverage determinations and shifting payer policy signal growing administrative burden for Medicaid-serving providers and plans working to reduce claim rework and reimbursement delays.