Revenue & ROI calculator
Medical Billing Revenue Leak Calculator
Most practices do not lose revenue in one big place. It leaks out in small amounts: a denial nobody worked, a claim paid below the contracted rate, a patient balance that never got a second statement, a balance aging.
What this calculator shows
Most practices do not lose revenue in one big place. It leaks out in small amounts: a denial nobody worked, a claim paid below the contracted rate, a patient balance that never got a second statement, a balance aging past 90 days. This calculator adds those leaks up from your own figures so you can see the size of the problem in dollars, per month and per year.
Enter the numbers from your practice management reports. Leave any field at zero if it does not apply to your practice yet; the estimate simply leaves that leak out.
Revenue & ROI calculator
Medical Billing Revenue Leak Calculator
See where revenue quietly leaks out of your billing each month.
How the calculation works
Unworked denials = claims x average reimbursement x denial rate x share never worked. Underpayment exposure = expected monthly reimbursement x underpayment rate. Patient gap = patient responsibility billed x (1 - patient collection rate). The monthly total adds your known timely filing losses; the year is the month x 12.
How to read your result
Treat the monthly figure as a map, not a verdict. The largest line tells you where to look first: unworked denials point to follow-up capacity, underpayments point to contract monitoring, and a patient gap points to statements, estimates and payment options. The A/R over 90 days line is money already billed and waiting; it is shown as exposure rather than added into the monthly leak, because it overlaps with the other lines.
The recoverable range assumes a practice recovers roughly a quarter to a half of the revenue at risk once the leaks are worked consistently. It is an illustrative planning range, not a promise about your practice. A free medical billing audit replaces these estimates with your actual claim-level numbers, and our denial management and A/R management pages explain how each leak gets closed.
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 the recoverable range a guarantee?
No. It is an illustrative range based on the assumption that consistent follow-up recovers part of the revenue at risk. What your practice can recover depends on payer rules, filing deadlines and how old the balances are, which is why an audit of real claims comes before any commitment.
What if I do not know my underpayment rate?
Leave it at zero and use the other lines. Many practices have never measured underpayments because paid claims look finished. Comparing a sample of remittances against your contracted rates is how the rate gets measured.
Why is A/R over 90 days not added to the monthly total?
Because it overlaps with denials and patient balances already counted. Adding it would double-count the same dollars. It is shown separately as exposure: money billed that gets harder to collect with every month it ages.
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.