Denial cost calculator
Estimate what claim denials cost your practice every year and what you'd gain by bringing your denial rate down.
Estimated annual cost of denials
$85,344
- Denied claims per month
- 112
- Revenue never collected / year
- $51,744
- Rework cost / year
- $33,600
- Potential gain at a 5% denial rate
- $54,864
Illustrative estimate based on your inputs. Not a guarantee of results.
How to use this calculator
Pull your claim count, average payment per claim and denial rate from your practice management system's reports for the last 90 days. If you don't know what share of denied claims are never recovered, 30–50% is a common starting assumption for practices without a dedicated denial workflow.
How to lower your denial rate
- Verify eligibility at intake and at every plan-year change
- Track authorizations with visit-count and expiry alerts
- Check time-based codes, add-ons and telehealth modifiers before submission
- Review denials by payer and code monthly, and fix the root cause
Read more: why mental health claims get denied and the fix for each.
Frequently asked questions
What is a good claim denial rate?+
Many practices aim for an initial denial rate under 5–10%. Behavioral health practices often run higher, around 12–20% according to industry reports, because of authorization and time-based coding rules.
How is the cost of a denial calculated?+
Two parts: revenue that is never recovered (denied claims that are never paid) and the staff time to rework and resubmit or appeal the rest. This calculator multiplies both by your monthly volume.
Find out where your practice is losing revenue
Send us a de-identified A/R and denial export. Within 48 hours you get a one-page report showing your biggest revenue leaks and how to fix them. Free, with no obligation.