PR Newswire·Oct 22, 2026, 9:00 AM ET

New Waystar and Modern Healthcare Research Reveals Significant Gaps in Providers' Ability to Prevent Payer Recoupments

42% of hospitals and health systems face at least $1 million in annual recoupment requests, with 10% reporting $25 million or more.
Payer recoupments are growing twice as fast as overall claim volume, creating significant financial exposure for providers.
83% of healthcare organizations lack full visibility into the root causes of individual recoupments, while 90% lack visibility into preventability.
74% of respondents report that post-payment adjustments negatively impact cash flow forecasting.
Eligibility and coordination-of-benefits issues are the leading drivers of recoupments (64%), followed by coding and billing errors (57%).
33% of organizations currently use AI or automation for recoupment management, while 43% are actively evaluating solutions.
Healthcare leaders identify better visibility into payer rules (46%) and automated end-to-end tracking (44%) as the most needed capabilities.
Waystar's AI-powered Recoupment Manager helps automate matching, improve visibility, and identify recurring issues for upstream prevention.
Client Respiratory Technologies achieved an 86.5% recoupment match rate and reduced time spent on balance adjustments by 80% using the platform.
Waystar serves over 30,000 clients, processes 7.5 billion transactions annually, and spans approximately 60% of U.S. patients.