Enter monthly claims, denials, average claim value and a recovery rate to see the denial rate and what it costs — monthly and annually.
Denials as money, not percentages
A denial rate on its own is easy to shrug at; the same rate expressed as monthly dollars is not. Enter claims submitted, claims denied, the average claim value and a realistic recovery rate, and this calculator returns the rate alongside the numbers that drive action: revenue denied per month, the recoverable share, and the annual exposure.
How to use it
- Enter monthly claim volume and denials.
- Enter the average claim value from your reports.
- Set a recovery rate — well-worked denial queues recover 55–70%.
The formulas
A worked example
2,000 claims a month with 180 denials is a 9% denial rate — against an industry-typical 5–10% and a best-practice target under 5%. At $185 a claim that’s $33,300 denied every month ($399,600 a year); at a 60% recovery rate, roughly $19,980 a month is winnable — and the remaining ~$13,000 is the permanent monthly cost of the denial rate itself, which is the number that funds prevention work.
Estimates only — payer contracts, plan documents and the EOB are always the source of truth, and nothing here is billing, legal or medical advice. The calculator runs entirely in your browser: no patient data is entered, transmitted or stored.