The Denial Cost Calculator

Which denial reason costs you the most? Sort by dollars and see.

What your denials cost you a month
$0

$0 of it is one reason: none yet.

A denial is the insurance company’s refusal to pay a claim, with a reason code. The denial report counts them. The cost is in what each one loses for good, plus what you pay someone to work it. The biggest pile is rarely the most expensive one.
Slide in last month’s counts. The starting values are an example. Watch the order change.

1Your billing team
Minutes to work one denial

Reading it, pulling the records, the call, the resend. A plain fix-and-resend takes less, a real appeal takes more. Use your average.

What an hour of billing staff costs you

Pay plus benefits, or what the billing company charges, by the hour.

Run this on your own denials in one sitting

Pull last month’s denials and sort them by reason and by insurer. Three hundred claim numbers usually collapse into eight or ten clusters. For each cluster, write down three numbers: the count, what one claim is worth, and the share that came back paid the last time you worked them.

Then sort by dollars instead of by count, and name one person for the top cluster. If the top cluster says information is missing, the remark code on the payment report says what. Read it before anyone sends the claim again.