Denial Cost Calculator
Every denied claim costs you three times: the revenue that never arrives, the staff time spent fighting it, and the write-off when nobody fights it at all. Enter your practice's numbers and see what denials actually cost you per year — no login, nothing leaves your browser.
Reference points, so you can sanity-check your inputs: Premier's 2023 survey found roughly 15% of private-payer claims initially denied, at an average rework cost of $43.84 per claim (2022); Change Healthcare's earlier analysis put hospital-side rework at $118 per claim and found 63% of denied claims are ultimately recoverable; Experian Health's State of Claims reports 41% of providers seeing denial rates above 10%. The widely quoted “65% of denials are never resubmitted” is an industry estimate without a public primary source — treat it as directional. Your own numbers beat any benchmark.
How the math works
No black box — four formulas, all driven by your inputs. Denied per year = claims × 12 × denial rate × average reimbursement. Never collected subtracts what your team wins back (denied × share reworked × recovery rate). Rework labor = denied claims × share reworked × cost per rework. Value of one point = what a single percentage-point drop in your denial rate is worth once you count both the avoided write-offs and the avoided rework labor. Estimates, not guarantees — your payer mix and appeal outcomes will vary.
Frequently asked questions
Four formulas, all shown on this page. Denied per year = monthly claims x 12 x denial rate x average reimbursement. Never collected subtracts what your team wins back (denied x share reworked x recovery rate). Rework labor = denied claims x share reworked x cost per rework. The one-point value counts both the avoided write-offs and the avoided rework labor from a single percentage-point drop in your denial rate. These are estimates, not guarantees - payer mix and appeal outcomes vary.
Premier's 2023 survey found roughly 15% of private-payer claims are initially denied, and Experian Health's State of Claims report found 41% of providers seeing denial rates above 10%. Well-run practices get materially lower. The number that matters is your own - pull it from your practice-management system's denial report.
Premier's survey put the average at $43.84 per claim in 2022, and Change Healthcare's hospital-side analysis estimated $118 per claim. Smaller practices often use ~$25 as a working estimate. The same analysis found 63% of denied claims are ultimately recoverable - which is exactly why unworked denials are so expensive.
No. The calculator runs entirely in your browser - nothing you type is stored, transmitted, or logged. Reload the page and it's gone.