Getting paid isn’t getting any easier. In fact, Tebra data shows that 40% of billers reported rising denial rates in the last year. Combine those denials with payer audits, cybersecurity risks, and maxed-out staff, and it’s easy to understand why operational pressures are so crushing for many medical practices. 

In our recent webinar, healthcare business consultant Aimee Heckman joined Tebra’s director of customer and partner marketing Amanda Zeosky and senior content marketing programs manager Miriam Datskovsky. Together, they shared Tebra’s exclusive new data and practical strategies for getting paid in 2026.  

Watch the full on-demand webinar below, or read on for tips to get started. 

You’re not imagining it: payer pressure is intensifying. Payers have jumped into AI to scrutinize and deny claims — often without human oversight. And automated audits are creating more payer “takebacks,” where payers demand payments be returned months after processing. 

Meanwhile, the Consumer Financial Protection Bureau (CFPB)'s rule to prevent medical debt from appearing on credit reports was struck down in July 2025 — yet similar laws are already in effect in some states. Providers and billing companies shouldn't count on credit reporting and collections as effective leverage. They need to focus on front-end processes, clearer financial conversations, and modern payment tools to capture every dollar.

New Tebra data found that these factors are increasing pressure on independent providers — with 45% saying the independent healthcare model is now “very” or “extremely” threatened, up from 41% a year ago. Providers want to remain independent, but need stronger collections, reduced administrative burdens, and more predictability from payers. 

“Think back to the early days of EHRs,” Aimee challenged. “Vendors made big promises, but it took the average practice years to see tangible, significant benefits.” 

Similar to the introduction of EHRs, the trick is choosing the right tool to solve a specific problem, rather than chasing a nebulous “better.” 

It’s important to understand that automation and AI are two distinct technologies. Automation efficiently executes predictable tasks based on rules that you define — helping offload the repetitive work from your team’s to-do list and flagging outliers that require human judgment. While AI learns patterns, makes predictions, and adapts over time to become smarter by internalizing your specific processes, needs, and use cases. 

Tebra data shows that 83% of billers say automation has reduced their time to get paid. That’s largely because automation can improve coordination between clinical and billing teams, ensuring that claims are complete and clean before submission while triaging exceptions back to humans. 

AI is still maturing, but among billers using it, nearly half say it helps reduce burnout. The biggest use case right now is AI-assisted documentation, which cuts a provider’s charting time while reducing errors. That means cleaner claims and less after-hours time required. 

Robotic Process Automation (RPA) is perhaps the strongest example of how billers are automating repetitive tasks and workflows, including ERA processing, analyzing conditions for special handlings, and posting unapplied payments. 

As Aimee pointed out, “RPA isn’t about replacing people. It’s about making their jobs easier and more satisfying so they stick around. It’s a proven way to reduce repetitive work, cut denial rates, and recover revenue faster.”

Yet 42% of billers haven’t adopted any automation at all — and Tebra data shows they’re the ones feeling least confident about their futures.

With payers ahead of the AI curve, it’s time for billers to start catching up. But in a fast-changing market, how do you find AI that will actually help your workflows? Aimee shared a list of questions to ask vendors who say they “do AI,” including:

Note: It’s critically important to have a partner who understands HIPAA compliance — not just an AI vendor trying to get into the healthcare market. 

Over time, security gaps can quietly slow payments and jeopardize contracts. A single breach can trigger fines and expensive rework, while eroding client trust. 

As Aimee explained, “Security isn’t just about preventing breaches … It’s also about proving you’re doing the right thing before there’s a breach or an audit.”

But data shows that security features like multi-factor authentication still aren’t universal. With only 41% of billers fully documenting their security processes, and just 24% conducting regular risk assessments. 

Aimee proposed several low-cost ways to boost cybersecurity, which are perfect to tackle in the new year, including:

The basics: Start with email filtering, antivirus software, and regular system updates. Consider working with a managed security service provider (MSSP) to monitor your systems and respond to incidents.

Training and access control: Use free resources from CISA to update your team on phishing and emerging threats. Restrict PHI access to only individuals who actually need it.

Response plan: Document how to detect, contain, and report a breach, including who’s responsible. 

Investing a few hours upfront in these tasks can protect your data, reputation, and bottom line. 

76% of healthcare financial leaders say denial management is their most time consuming RCM task. As payers automate more denials and appeals grow more complex, the most effective strategy is prevention, which requires identifying patterns and closing workflow gaps before claims go out. 

Aimee encouraged looking at where denials originate. One of the most common culprits is coordination of benefits. For example, 45% of billers now cite COB issues as the top denial driver as payers become more sophisticated at detecting other coverage. 

Strong front-end workflows — confirming primary and secondary insurance, validating demographics, and resolving eligibility questions before the visit — can eliminate many of these denials outright. 

Payer behavior is also changing. Many insurers now rely on AI to issue denials with limited human review. Additionally, CPT downcoding has increased, unspecified codes are scrutinized more closely, and documentation that once passed may now be rejected. 

The takeaway: accuracy the first time matters more than ever. It’s important to tighten documentation practices, review templates and carry-forward notes, and ensure coding aligns precisely with what was addressed (and documented). These types of small process improvements can significantly reduce denials, prevent takebacks, and protect revenue. 

Aimee suggested 5 actions to improve your revenue and boost your confidence in 2026: 

Small changes can add up. Collecting just two additional $40 copays per day adds $20,000 to your bottom line over the course of a year. 

Want more details and tips on preparing for a stronger 2026? Check out the full discussion with Aimee, Amanda, and Miriam. Watch the on-demand webinar now, or download the slides.