Free tool
What are claim denials costing your practice?
Denials are usually treated as an operational nuisance rather than a number. This turns them into one — using published benchmarks, with every source shown.
Across all providers
Allowed amount, not billed charge
First-pass denials, if known
Estimated annual revenue at risk
$190.1K
From roughly 864 denied claims a year. Around $133.1K of that is typically recoverable on appeal — and about 726 of those denials were avoidable in the first place.
- Recoverable on appeal
- $133,056
- Annual cost just to rework them
- $49,447
Takes 2 minutes. No sales pitch.
Method: denied claim volume × average claim value. Recovery applies Premier Inc.’s finding that ~70% of denied claims are overturned when appealed (2023); rework cost uses Premier’s $57 per contested claim; the avoidable share uses Optum’s 84% figure (2023). This is an estimate for orientation, not a quote — a billing audit measures your actual numbers.
The benchmarks behind it
Where these numbers come from
Medical billing marketing is full of statistics with no traceable source. Every figure this calculator uses names its publisher, dataset and year.
~70%
of denied claims are overturned and paid on appeal
$57.23
average cost to fight a single denied claim
84%
of claim denials are potentially avoidable
8%
first-submission denial rate, physician practices
41%
of providers report denial rates above 10%
$18B
spent annually adjudicating claims that should have paid
Questions
About this calculator
Denied claim volume is your monthly claim count multiplied by your denial rate, annualized. That is multiplied by average claim value to give total denied revenue. The recoverable portion applies Premier Inc.'s finding that approximately 70% of denied claims are overturned when appealed, and the rework burden uses Premier's measured cost of $57.23 per contested claim.
Use your average allowed amount rather than your billed charge. Billed charges are typically well above contracted rates, so using them inflates the result substantially. If you do not know your allowed average, dividing total collections by claim count for a recent month is a reasonable approximation.
Use the benchmark for your setting. MGMA reports an aggregate first-submission denial rate of 8% for single-specialty physician practices. Kodiak Solutions measured 11.81% across hospitals and health systems. If you have never measured it, starting at 10% is a defensible assumption — and measuring it is the first thing a billing audit does.
An estimate for orientation. It applies published industry benchmarks to numbers you supply, which means it cannot account for your specific payer mix, specialty, or which denials are genuinely recoverable in your case. A billing audit measures your actual figures rather than modeling them.
Find out what your denials are costing you
A free billing audit reviews your denial rate, AR aging and clean claim rate against industry benchmarks. Takes about two minutes to request. No sales pitch.
No setup fees · You pay when we collect · Pricing from 3% of net collections