The Underpayment You Can't See

Highlights

• The metric gap: A 99%-plus clean claim rate is the industry benchmark, and it tells CFOs nothing about whether every paid claim was paid the amount the contract promised.[1]
• The scale of the visible problem: Hospitals lost more than $48 billion to final denials and bad debt in 2025, up 25% from $38.6 billion in 2024, driven almost entirely by clinical denials.[2]
• The invisible half: Independent analysis puts underpayments that never trigger a denial at 1% to 5% of net patient revenue a year, recovered only if someone goes looking for them.[3]