Free calculator
What one denied claim actually costs
A denied claim costs you twice: the staff time to rework it, and — far more often — the entire reimbursement, when nobody reworks it at all. Change the inputs to match your practice.
Estimated annual cost of denials
$102,000
About $8,500 a month — roughly $85 for every claim that comes back denied.
- Denials per month
- 100
- Never reworked
- 60
- Revenue never collected / month
- $7,500
- Staff cost to rework / month
- $1,000
The larger number here is almost always the revenue that was earned and simply never collected — not the staff time. That is the part that does not appear on any report, because a claim nobody reworked stops generating paperwork.
Find out what your real numbers are
This is an estimate built on industry averages. The billing leak checklist walks you through pulling your actual denial log — including the one column that tells you whether anyone is reworking them at all.
How this math works
Four steps, all of them arithmetic you can check.
- 1. How many claims come back denied. Industry estimates put roughly 10% of claims denied on first submission. This varies meaningfully by specialty — surgical and prior-authorization-heavy practices run higher.
- 2. How many of those get worked again. The commonly cited estimate is that around 60% of denials are never reworked. Not appealed, not corrected, not resubmitted — closed.
- 3. What the abandoned ones were worth. Every denial nobody touches again is the full allowed amount, gone. This is almost always the biggest number on the page, and it is invisible: a claim nobody is working stops generating paperwork.
- 4. What the reworked ones cost to chase. Estimates commonly start at $25 per rework in staff time. That cost is real even when the claim eventually pays.
A high denial rate is not automatically a billing problem. Eligibility and prior-authorization denials originate at the front desk, and no amount of billing performance fixes those downstream. The billing leak checklist shows you how to tell which one you have.
The default values above — roughly 10% of claims denied on first submission, around 60% of denials never reworked, $25+ per rework — are industry estimates. They vary by specialty and payer mix and are not predictions about your practice. This calculator produces an order-of-magnitude estimate, not a projection of recoverable revenue. Nothing you enter is submitted or stored.