Survey finds hospitals and medical practices face long payment cycles, costly billing systems, and a rising demand for AI-driven automation

Smarter Technologies, the automation and insights platform for healthcare efficiency, in partnership with MedCity News, today released the results of its 2025 Revenue Cycle Management (RCM) Survey, shedding light on the challenges hospitals and medical practices face in securing timely reimbursement and managing billing operations.

The findings highlight a system under strain. Hospitals and practices are caught between rising administrative complexity and financial pressure. Slow reimbursements and cumbersome billing processes not only impact cash flow, but also divert staff from patient-facing responsibilities. Respondents made it clear that current tools are falling short, underscoring the need for technology that streamlines operations, reduces manual work, and provides actionable insights.

When asked about billing software, respondents cited high costs, coding errors, and complex usability as top challenges. Negative experiences frequently stemmed from unreliable software, lack of integration with existing systems, and poor customer support. However, respondents highlighted a strong demand for solutions that are intuitive, integrate seamlessly, and provide features such as real-time claims tracking, customizable dashboards, and built-in compliance tools.

Key findings include:

• Slow payments: More than 40% of respondents said it takes two months or longer to receive payment for a medical bill. Nearly half report average cycles of 6–8 weeks, and almost 20% said Medicaid payments stretch beyond six months.
• Software struggles: The top billing software complaints were that it’s too expensive, prone to coding errors, and overly complicated. Some organizations said their systems lacked basic denial tracking, created more work than they saved, and came with poor customer support.
• High cost of collections: 20% of organizations surveyed said it costs them more than 10% of a bill just to collect payment.
• Denial rates: Large systems reported greater challenges, with 36% of hospitals handling 10,000+ discharges annually facing denial rates of 10% or more.
• AI interest: More than 90% of respondents expressed interest in AI-driven billing solutions, with top priorities being bill collection, patient financial services, and payer communication.

The survey also revealed growing optimism around AI-enabled revenue cycle solutions:

• Sixty-six percent already have experience with AI-led vendors, and most described the experience as positive.
• Respondents identified bill collection, patient financial services, and payer communication as the RCM areas where AI could make the greatest impact.
• Automating tasks such as eligibility verification, denial management, payment reconciliation, and predictive analytics were seen as a major opportunity to improve staff productivity and reduce burnout.

“Revenue cycle inefficiencies remain a major drag on healthcare organizations, but this survey makes it clear leaders see AI and automation as the path forward,” said Mike Gao, MD, President of Smarter Technologies. “Hospitals and practices want technology that doesn’t just reduce errors and speed up reimbursements — they want tools that give their staff time back, make patient billing easier, and ultimately help them focus on care instead of paperwork.”

The findings also underscored how organization size influences experiences: larger health systems reported higher denial rates and greater frustration with inefficient or expensive software, while smaller practices were more likely to struggle with complicated systems.

"We’re proud to collaborate with Smarter Technologies on this inaugural report," said Ken Montgomery, Publisher of MedCity News. "The findings reinforce trends we’re seeing across our newsroom and conferences, particularly the growing demand for AI solutions that streamline prior authorization and billing processes that help organizations make more informed revenue cycle management technology decisions."

The full survey results are available: https://www.smarter-technologies.com/2025-medcity-news-ai-rcm-survey-results

Survey Details and Methodology

MedCity News surveyed 125 medical billing executives and support staff, from CEOs through medical billing managers. They represent organizations of all sizes, from medical practices with 5,000 or fewer annual patient discharges to large hospitals with more than 10,000 discharges each year.

The majority of respondents, 55%, have worked in healthcare six years or more. Half of respondents, 50%, work at hospitals with 5,000 to 10,000 patient discharges annually. Another 26% work for practices with more than 10,000 patient discharges annually, while the rest, 25%, work for practices with less than 5,000 discharges per year.

About Smarter Technologies

Smarter Technologies, the automation and insights platform for healthcare efficiency, is a leading AI-powered revenue management platform that combines proprietary clinical agents, human-in-the-loop AI Agents, clinical ontology and global financial and administrative services that allows healthcare organizations the flexibility to automate the entirety of their administrative and financial workflows to optimize operational outcomes and drive better patient experiences. For more information, visit: www.smarter-technologies.com.

View source version on businesswire.com: https://www.businesswire.com/news/home/20251022529767/en/

Smarter Technologies and MedCity News Reveal Key Insights from 2025 Revenue Cycle Management Survey.