RESEARCH + INSIGHTS
Recoupments: Gaining visibility into post-payment risk and recovery
New research reveals how healthcare organizations are managing payer recoupments, improving visibility, and strengthening post-payment recovery.
Financial risk doesn’t end when a claim is paid
For years, healthcare organizations have focused on preventing denials, accelerating reimbursement, and improving performance before and during claim payment. But payer recoupments are creating a different challenge: protecting revenue after payment occurs.
New research from Waystar and Modern Healthcare reveals the scale of that exposure and the difficulty organizations face in managing it:
49%
rank recoupments among their top
three revenue cycle challenges
74%
say post-payment adjustments affect
revenue and cash-flow forecasting
26%
receive $1 million or more in
annual recoupment requests
Only 17%
have full visibility into the root causes
of recoupments
Recoupments can surface months or even years after a claim is paid, require significant staff time to investigate and resolve, and often trace back to issues that began much earlier in the revenue cycle.
The findings point to a more strategic approach to recoupment management: improving visibility, identifying risk earlier, prioritizing the right response, and surfacing recurring causes that may create opportunities to reduce future exposure.
Publication date: October 2026
What you’ll learn:
- 1 The scale of recoupment risk and financial exposure
- 2 The upstream issues driving payer takebacks
- 3 The operational burden on revenue cycle teams
- 4 The visibility gaps making recoupments harder to manage
- 5 The role of AI and automation in improving recoupment recovery and response
Get the report
EXPLORE THE RECOUPMENT CHALLENGE
Healthcare RCM leaders on recoupment complexity
Hear healthcare leaders discuss why payer takebacks remain difficult to track, investigate, and manage at scale.
AI-powered recoupment management
See how AI-powered automation can help healthcare organizations identify, match, and resolve payer takebacks with greater speed, accuracy, and visibility.
Why recoupments are a billion-dollar problem
Industry experts from leading healthcare organizations explore the scale, causes, and growing impact of payer takebacks across the revenue cycle.
