QUARTERLY REPORT

DENIAL MANAGEMENT
INDEX Q1 2026.

The industry's first insider report on payer denial behavior. Rankings, trends, and predictions from 20 years of pattern analysis.

Methodology

The CoverageUnlocked Denial Management Index synthesizes data from six authoritative sources:

CMS MAO Denial Data

Medicare Advantage Organization public submissions

KFF Marketplace Analysis

ACA marketplace denial trends and insurer behavior

AHA Administrative Cost Surveys

Provider-reported denial and appeals burden data

State DOI Enforcement Records

Department of Insurance complaints and settlements

JAMA Health Forum Research

Peer-reviewed studies on algorithmic denials

20 Years of Insider Intelligence

Confidential payer behavior patterns from Ned Lutz

All data sources are public or publicly available. We add insider interpretation and context that only comes from 20 years inside the insurance industry.

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Complete payer rankings, regulatory updates, denial hotspots, and insider methodology.

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For enterprise clients: Customized denial management insights for your payer mix and service lines.

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The Denial Management Index is published quarterly by CoverageUnlocked.

Data Sources & Citations

  • CMS MAO Data: Medicare Advantage public denial submissions via CMS.gov
  • KFF Marketplace: Henry J. Kaiser Family Foundation marketplace analysis and state filings
  • AHA Survey Data: American Hospital Association administrative cost and appeals burden studies
  • State Enforcement: State Departments of Insurance complaint databases and settlement records
  • JAMA Research: JAMA Health Forum: "The Impact of Automated Denials on Patient Care and Provider Burden" (2025)
  • Insider Intelligence: 20 years of healthcare insurance operations experience + confidential payer data patterns

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