Denial Rate Calculator

Claims denial rate and revenue impact analysis.

Total claims per month

Current denial rate (%)

Avg claim value ($)

Appeal success rate (%)

Cost per appeal ($)

Target denial rate (%)

Billing staff hourly rate ($)

Tab to move between fields

Denied claims per month

120

Annual revenue at risk

$266,400

Clean claim rate92%

Monthly revenue at risk$22,200

Monthly recovered via appeals$6,475

Annual appeal costs$43,056

Net annual revenue lost$188,700

Savings from hitting target$133,200

Est. days in AR impact16

Annual Recovered77,700

How to Use This Calculator

Enter Total claims per month and your Current denial rate (%) — the national average is 5–10%.
Input Avg claim value and Appeal success rate (%) to model the revenue recoverable through the appeals process.
Set Cost per appeal and Billing staff hourly rate to capture the true cost of working denials.
Enter your Target denial rate (%) to project the Savings from hitting target after implementing improvement initiatives.
Review Monthly revenue at risk and Annual revenue at risk to quantify the business impact of current denial levels.
Use Days in AR impact and Clean claim rate to benchmark performance and set billing team improvement goals.

Ad Placeholder