Denials in 2026: The New Normal—or a Preventable Problem?

Claim denials have become more sophisticated in 2026, driven by automation and payer-specific logic rather than simple errors. Many denials now stem from documentation alignment issues, coding frequency thresholds, or perceived medical necessity conflicts—not obvious mistakes.

What makes modern denials especially costly is the time required to resolve them. Appeals demand precise documentation, timely follow-up, and payer-specific knowledge. Without a structured denial management process, practices risk writing off revenue that could have been recovered.

D’Souza and Associates approaches denial management as a prevention strategy first. We analyze denial patterns, identify root causes, and implement corrective workflows that reduce repeat issues. When appeals are necessary, our team manages them with urgency and accuracy to protect reimbursement.

In 2026, denial rates are a reflection of process quality. Practices that address denials proactively regain control of revenue instead of reacting after losses occur.