Revenue Risk calculator
Timely Filing Revenue Risk Calculator
Every payer sets a deadline: file within a set number of days of service or the claim is not payable, however good the care was. This calculator looks at the claims you know are affected, perhaps from a billing gap, a.
What this calculator shows
Every payer sets a deadline: file within a set number of days of service or the claim is not payable, however good the care was. This calculator looks at the claims you know are affected, perhaps from a billing gap, a system change or a coverage transition, and estimates how much of their value could become unrecoverable.
The unrecoverable percentage is your assumption to choose. Use a low share if most claims are still inside their windows, and a higher one where deadlines have already passed. The assumptions are labelled in the results so nobody mistakes the estimate for an audit finding.
Revenue Risk calculator
Timely Filing Revenue Risk Calculator
Claims close to a filing deadline: what could become unrecoverable?
How the calculation works
Total represented = affected claims x average reimbursement. Estimated unrecoverable = total represented x unrecoverable percentage. Still at risk = total represented minus the estimated unrecoverable amount.
How to read your result
The practical move is triage: sort affected claims by payer deadline and dollars, file what is still fileable today, and document the rest for write-off decisions. Our timely filing limits guide lists how the windows work, and the revenue leak calculator includes a line for losses you already know about, so the two views agree.
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.
Do filing deadlines ever get extended?
Occasionally, with proof the claim was filed on time or that the payer caused the delay. Keep submission receipts; they are the evidence those exceptions run on.
Is an unrecoverable claim the same as a denial?
It becomes one: payers deny for timely filing, and those denials are rarely overturned without proof of timely submission.
How do practices end up with affected claim batches?
Staff turnover, billing system migrations, a payer portal outage nobody documented, or claims held waiting on documentation. The triage is the same regardless of cause.
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.