New York – October 13, 2026 -- U.S. specialty practices in six fields have an estimated $108 billion in annual recoverable revenue, equal to about $125,000 per physician or 11% of annual revenue, according to new research from voice AI vendor Prosper AI. The analysis covers dermatology, ophthalmology, gastroenterology, OB-GYN, primary care and orthopedics.
Four revenue levers add up to $125,000 per physician
Prosper AI splits the gap into four sources:
- $44,800 from answering calls and filling schedules
- $37,400 from bringing patients back for follow-up care
- $28,500 from preventing avoidable denials
- $14,100 from recovering patient balances
One in six calls to specialty practices goes unanswered during office hours, and the share climbs to 81% after hours. Only 54% of patients due for a follow-up visit return on schedule. Another 40% come back late and 6% never return.
On the back end, front-end errors drive nearly half of claim denials. Examples include billing an inactive insurance plan, skipping a required insurer approval and misspelling a patient's name. Patients now pay 36% of the cost of their care, and nearly 8% of what they owe goes unpaid.
Medicare rate boost expiring while costs climb
A temporary 2.5% boost in Medicare reimbursements expires at the end of 2026, and the Centers for Medicare & Medicaid Services has said it has no plans to renew it. Commercial health plans benchmark contract rates against Medicare fee schedules, so the impact reaches a practice's whole payer mix.
Costs are rising at the same time. MGMA data show 84% of medical groups report higher operating costs than a year ago, with an average increase of 11%. The American Medical Association says inflation-adjusted Medicare physician payments have fallen 33% since 2001.
Practices have traditionally added administrative staff to cope, a solution that grows more expensive as labor costs rise. KFF data show three in 10 adults find it difficult to understand what they will owe out of pocket.
No-shows rise as affordability worries grow
MGMA reports that 32% of medical groups saw more no-shows in 2026 than in 2025, while 10% saw fewer. Prosper AI proposes a "benefit-verified appointment": an AI system confirms coverage, calculates the patient's cost and shares it before the visit.
Prosper AI CEO Xavier de Gracia said practices "can't control reimbursement rates, but they have more control over growth than they think."
North Carolina group books 17% more appointments with fewer providers
Piedmont Plastic Surgery and Dermatology, a Prosper AI customer, was receiving 28,000 calls a month and answering about 60% of them before deployment. Chief Operating Officer Noah England said appointments booked across its 37 providers rose 17% year over year in August, even though the group has fewer providers than a year earlier. He named referral scheduling and patient cost clarity as next revenue opportunities.
Study combines call audit of 2,000 practices with MGMA data
Prosper AI drew on interactions across patients and insurers covering more than $3 billion in managed care and combined them with specialty-specific MGMA data. Its CallIQ phone-access study attempted to reach about 2,000 practices across 29 states. For each call it tracked time to a live answer and time to begin scheduling, and no appointments were booked. The report also uses federal data from CMS, AHRQ and CDC, plus peer-reviewed studies on follow-up adherence, claim denials and patient responsibility.