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Revenue leakage calculator

Denials that never get appealed. Claims paid below the allowed amount that nobody catches. Move the sliders to your own numbers and see what an average month leaves on the table.

250
$1,800
12%
Industry average is 10–15%. Under 5% is best-in-class.
Estimated recoverable revenue
$33,750/month
That’s 169× the cost of PayerVista ($199.99/month) — sitting in denials and underpayments most teams never get time to work.
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Estimate assumes 50% of denied dollars are recoverable when worked before appeal deadlines (industry range: 50–65%) and underpayments of 1.5% of billed charges. Your actual figure comes from your own remittance data.

How the estimate works

How is the estimate calculated?

Monthly billed charges are your claim volume multiplied by average claim value. Denied dollars are that figure multiplied by your denial rate. The estimate assumes half of denied dollars are recoverable when worked before appeal deadlines, and adds 1.5% of billed charges for underpayments — claims paid below the contracted rate.

Why assume only half of denials are recoverable?

Because it is the conservative end of the commonly cited range. Industry sources generally put the recoverable share of denials somewhere between 50% and 65% when they are worked before appeal windows close. Using the low end keeps the estimate defensible rather than flattering.

What counts as an underpayment?

A claim the payer paid, but paid below the contracted allowed amount. Nothing denies and nothing rejects, so it closes as paid — which is why underpayments are invisible to any workflow organised around denials, and why they are excluded from most practices’ own estimates of revenue leakage.

Do I have to sign up to use it?

No. The calculator runs entirely in your browser and requires no account. You can optionally have the estimate emailed to you.

Where the leakage actually comes from

The estimate above is an aggregate. In practice, the losses concentrate in a small number of recurring causes — and each one has a specific, fixable failure behind it.

CO-197 · Prior authorization missingCO-29 · Timely filing expiredCO-50 · Medical necessityCO-45 · Exceeds fee scheduleUnderpayments explainedNet collection rate

Replace the estimate with your actual number

Upload your 835 remittance files and PayerVista shows the real figure — denials by reason and payer, claims paid short, and what each is worth. Free 14-day trial, no credit card required.

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This calculator produces an estimate from the inputs you provide and the stated assumptions. It is not a guarantee of recoverable revenue, and actual results depend on your payer mix, contracts, and how quickly denials are worked.