Claims & Denials calculator
Denial Revenue Calculator
A denial rate is a percentage; this calculator turns it into money. Multiply your denied claims by your average reimbursement and you get the revenue those claims represent, for a month and annualized. Not all of it is.
What this calculator shows
A denial rate is a percentage; this calculator turns it into money. Multiply your denied claims by your average reimbursement and you get the revenue those claims represent, for a month and annualized. Not all of it is lost: some denied claims are corrected, appealed and paid. That is why this page calls it revenue at risk, not lost revenue.
If you do not know your denied claim count, start with the denial rate calculator and your clearinghouse report.
Claims & Denials calculator
Denial Revenue Calculator
The dollars represented by your denied claims, per month and per year.
How the calculation works
Revenue at risk = denied claims x average expected reimbursement. The annualized figure is the monthly figure x 12. It represents the value of denied claims before any are corrected, appealed or paid.
How to read your result
The right response to this number is a queue, not a panic: work denials inside their appeal windows, starting with the largest and oldest. Denial management exists for exactly that queue, and our guide to appealing a denied claim shows what a good appeal packet contains. How well appeals are going is measured with the appeal success rate calculator.
Looking for another measure? See all medical billing calculators or the formulas collected in our medical billing KPIs guide.
Before you rely on the number
Results are estimates for educational and operational planning, built from the figures you enter. They are not guarantees of reimbursement, savings or recovery, and they do not replace a review of your own claims, contracts and remittances. Do not enter patient-identifiable or protected health information: this calculator runs in your browser and nothing you type is stored or sent anywhere.
FAQ
Calculator questions
Still have a question? Talk to our team about your billing workflow.
Is denied revenue the same as lost revenue?
No. Some denied claims are later paid after correction or appeal; some are true write-offs. This calculator shows the value at risk before follow-up, which is the honest planning number.
What average reimbursement should I use?
Total payments divided by paid claims for the same period is a fair rough figure. Specialty-heavy practices can run it per specialty for a sharper picture.
How often should I calculate this?
Monthly, alongside denial rate. The trend matters more than any single month.
Want this run on your real claims?
A free billing assessment reviews your actual denials, A/R and contracts, then gives you these numbers from your own data, in writing, before you decide anything.