Calculator
Denied revenue calculator
Behavioral-health claims are denied far more often than general medical claims, and most denied dollars are never appealed — even though roughly half or more of appealed denials are overturned. Enter your volume to see what the gap is worth.
Denied-revenue picture
Dollars denied per month$39,900
Recovered at your appeal rate$9,576
Left on the table each month$11,970
Illustrative estimate from your inputs. Assumes 60% of appealed behavioral-health denials are overturned (published figures range 47–82% by payer) and a 90% achievable appeal rate. Your remittance data measures the real figure.
Interpretation guide
How to use this number
Use the output as a decision aid: verify the inputs, read the operational signal, then choose what to measure or change next.
Start from your remittance data
Pull last quarter's claim count, denial rate and average allowed amount from your clearinghouse or billing reports rather than guessing.
Be honest about your appeal rate
Count only denials that were actually resubmitted with new evidence. Industry data suggests most groups appeal well under half.
Read the bottom line as a monthly habit
The unrecovered figure recurs every month you leave the appeal workflow understaffed. It is a rate, not a one-time amount.
Method & assumptions
Dollars denied equal monthly claims times denial rate times average claim amount. Recovery applies your current appeal rate and a 60% overturn assumption (published behavioral-health figures range 47–82% by payer). The achievable scenario assumes 90% of denials get a documented appeal. All assumptions are stated on the tool.
Continue the workflow
Want the real number, not an estimate?
Bring your inquiry log and current workflow. We will map your actual funnel in a 20-minute working session.
Book a workflow demo