MGMA poll: 63 percent of groups adding revenue cycle automation under payer pressure

In an Oct. 20 MGMA Stat poll, 63 percent of 214 respondents said their organizations are moving toward more revenue cycle automation in 2026, Physicians Practice reported. Another 26 percent expected no major change and 11 percent were shifting toward more manual work, citing payer complexity, tool gaps and staffing. Coding led the tasks being automated, followed by prior authorization, denials and appeals, and payment posting. The driver is payers: MGMA notes 90 percent of practices in its 2026 Regulatory Burden Report said prior authorization burden grew over the prior 12 months, and Medicare Advantage automatic downcoding is the fastest-growing member complaint it hears.

The EHR is the first place to look. MGMA's Julia Rosen advised checking AI tools already built into the EHR before paying for standalone products, starting with denial root-cause analysis on remittance files. Under the CMS Interoperability and Prior Authorization final rule, covered payers generally must have prior authorization APIs in production starting Jan. 1, 2027, and MGMA suggests pressing EHR and practice management vendors this quarter on which payers will connect, when and at what cost. Harvard Medical Faculty Physicians' Shannon Cameron cautioned that automating a flawed process repeats the mistake faster across thousands of claims.

A separate HIT Consultant opinion by Feynman Xu, founder and CEO of MedArise, which sells managed administrative AI, argues the missing cost in these business cases is exception handling. Missing demographics, duplicate records, expired credentials and payer discrepancies do not vanish when the routine path speeds up; they become a separate queue someone must detect, route and close. He proposes measuring completed, auditable outcomes rather than activity, and tracking backlog age, reopened work, unresolved exceptions and staff touches.

The evidence has limits. The MGMA poll measures intent to adopt, not results, and MGMA did not publish percentages by task. The exception-handling argument is opinion from a vendor executive, though its logic maps directly to the denial and prior authorization queues groups are targeting.

The move for CFOs, COOs and AI leaders: require every revenue cycle automation proposal to state the expected exception rate and who works the exceptions before approval. Pilot on one bounded queue with a captured baseline. The return is real capacity for billing teams, whom Kem Tolliver of Medical Revenue Cycle Specialists says are driven out by outdated tools and repetitive manual work, rather than a new dashboard to supervise.

You are a revenue cycle and finance advisor to the executive team of [your organization], a medical group weighing new revenue cycle automation.

Context. In an Oct. 20 MGMA Stat poll, 63 percent of 214 respondents said their organizations are moving toward more revenue cycle automation in 2026, Physicians Practice reported. Another 26 percent expected no major change and 11 percent were shifting toward more manual work. Coding led the tasks being automated, followed by prior authorization, denials and appeals, and payment posting. MGMA's Julia Rosen advised checking AI tools already built into the EHR before paying for standalone products. In a HIT Consultant opinion, Feynman Xu, founder and CEO of MedArise, which sells managed administrative AI, argues that exception handling is the missing cost in these business cases. Missing demographics, duplicate records, expired credentials and payer discrepancies become a separate queue someone must detect, route and close. He proposes tracking backlog age, reopened work, unresolved exceptions and staff touches. The poll measures intent to adopt, not outcomes, and the exception-handling argument is opinion from a vendor executive.

Task. Draft an approval standard that requires every revenue cycle automation proposal to state the expected exception rate and who works the exceptions before approval. Apply it to [the proposal or pilot under review], scoped to one bounded queue in [your EHR] with a captured baseline.

Output. A one-page memo for the executive team with these sections: Why this standard; Required fields in every proposal; Baseline for the pilot queue; Measures after go-live; Questions to verify before approval.

Use my numbers: [the queue to pilot, such as denials or prior authorization], [current monthly volume in that queue], [current staff hours per week working that queue], [the named owner for exceptions].

Guardrails. Use only the facts above and the slots I fill. Cite Physicians Practice and HIT Consultant by name. Flag anything uncertain or that needs verifying, and do not invent exception rates or results. Use no patient data. Nothing here is medical advice. State that this is a draft for the team to check.