Free Tool
Claim Denial
Cost Estimator
See how much revenue your denial rate costs each year — and how much you recover by bringing it down with dedicated denial management.
Quick Answer
Every denied claim is revenue at risk. At a 10% denial rate on average reimbursement, a typical practice writes off six figures a year. Cutting denials toward a 5% benchmark — what a dedicated remote biller focuses on — recovers much of it. Enter your numbers to see the gap.
Based on Zedtreeo's actual pricing. Dedicated remote staff from $1,056/month.
These figures are estimates for planning only. Your actual rate depends on role, scope, seniority, and engagement; market comparisons use representative benchmarks, not live quotes. Estimates only, not financial or medical-billing advice. No PHI is collected. Spotted a number that looks off, or have an idea to make this tool better? — we read every note and use it to improve these tools.
Methodology
How the Claim Denial Cost Estimator works
How the number is produced
- Denied revenue per year = monthly claims × average reimbursement × your denial rate × 12.
- Recoverable revenue = the same formula using only the gap between your rate and a 5% benchmark (denial − 5%).
- Monthly recoverable = annual ÷ 12.
Assumptions built in
- 5% is a commonly cited best-practice denial-rate target, not a guarantee of what dedicated follow-up will achieve for your payer mix.
- Treats denied claims as fully at risk; in practice a share is overturned on appeal, which the estimate does not net out.
- No PHI is collected — the inputs are volumes and averages only.
Benchmarks & sources
- MGMA DataDive & HFMA MAP Keys — revenue-cycle KPI benchmarks (2024)Used for: the commonly cited best-practice targets for claim denial rate (~5%), clean-claim rate and days in A/R that the medical tools use as the 'well-run' comparison point.
- Zedtreeo Rate Index (2026)Used for: the offshore hourly rate per role used on the Zedtreeo side of every comparison — the same figures quoted on our service pages.
- U.S. Bureau of Labor Statistics, OEWS May 2025 — Medical Records Specialists (SOC 29-2072) (2024)Used for: US wage baseline for the billing/records role the comparison replaces.
Methodology and constants last reviewed against the Zedtreeo pricing engine and Rate Index. Estimates are for planning; your quote depends on role, scope and engagement.
Claim Denial Cost Estimator FAQs
Common questions about this tool and the roles behind it.
It's the revenue between your current denial rate and a 5% well-run benchmark: monthly claims × reimbursement × (your rate − 5%) × 12. It estimates what dedicated denial management can capture, not a guarantee.
Request a quote and we'll shortlist pre-vetted candidates matched to your needs within 48 hours, with a free 5-day trial so you can confirm fit before committing.
Related Tools
Continue your analysis with these recommended tools.
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Try it free →Medical Coding Cost Benchmarker
Compare your per-claim coding cost against a dedicated remote certified coder.
Try it free →More free medical billing & RCM tools
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