How often claims are denied, and what it costs
Sources: Premier Inc., claims denials analysis, March 21, 2024 (516 hospitals, 36 states, claims from calendar year 2022); Experian Health, State of Claims survey, September 22, 2025 (250 healthcare professionals responsible for financial, billing, or claims management decisions).
The top causes of denials
Each of these can be caught before the claim is built — at registration, at eligibility, and at authorization — which is where a denial is cheapest to prevent.
How a denial becomes a write-off
A denial becomes a write-off when nobody works it in time: the appeal deadline passes, the corrected claim is never sent, or the balance is adjusted off because the effort looked larger than the payment.
Premier's figures show why that is expensive. More than half of private-payer denials were ultimately overturned and paid, so a denial left unworked is often revenue that could have been collected — given up to save a rework cost that averages about $44 per claim.
How to reduce denials and write-offs
Prevent at the front end. Verify eligibility and benefits before the visit, secure prior authorization before the service, and catch registration and data errors before the claim is built.
Edit before you submit. Run payer-specific edits on every claim before it leaves.
Work every denial, by root cause. Categorize each denial, fix the cause, and appeal with the reason the payer gave — inside the payer's deadline.
Follow up on claims that go quiet. A claim with no response is not a paid claim. Automated status checks find them before they age past timely filing.
Denial prevention and recovery with StreamClaim
StreamClaim validates every claim against 4,000+ edit rules before submission, tracks claim status with automated follow-up, categorizes denials by root cause, and drafts AI appeal briefs for a provider to review. It works with StreamVerify (eligibility), StreamAuth (prior authorization), and StreamStatus (claim status follow-up) on one shared data layer, so eligibility, authorization, and data problems can be caught before the claim is built.
Sources: Premier Inc., claims denials analysis, March 21, 2024 (516 hospitals, 36 states, claims from calendar year 2022); Experian Health, State of Claims survey, September 22, 2025 (250 healthcare professionals responsible for financial, billing, or claims management decisions).
Figures are from the third-party research cited, for general information; results for any individual practice will differ.