Denials Calculator

Welcome to the ABILITY Value Estimator

In about the same time it takes to get a cup of coffee, this tool will tell you how much money it costs your organization to recover outstanding revenue from suspended and denied Medicare and commercial claims.

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The basic information used in this tool can be found in most end-of-month reporting.
All values inserted into the tool should be monthly totals.
If you are not sure about a value, click DEFAULT to insert an industry average percentage.

Get started

Commercial Payers

Are you Medicare only? Click to skip commercial and dive into your Medicare claims.

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Let’s begin with commercial payers.

What amount do you bill out monthly to commercial insurance?

What is your overall denial rate for commercial claims? Not sure? According to the AAFP, the average denial rate is between 5% ‒ 10%.¹

Commercial Payers

What percentage of your monthly claims are rejected because of preventable errors like missing information, coding errors, challenges with payer-specific rules and/or sequential billing errors, etc.?

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What percentage of your claims get written off each month due to timely filing limits?

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What percentage of your monthly denials are due to eligibility issues such as changes in coverage or inactive plans?

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Commercial Payers

How many full-time employees (FTEs) are assigned to research, correct, and rebill denied commercial claims?

What percentage of their time is used for these activities?

Up next, Medicare…

Medicare

What amount do you bill out to Medicare monthly?

What is your overall denial rate for Medicare? Not sure? According to the AAFP, the average denial rate is between 5% ‒ 10%.¹

Medicare

What percentage of your monthly claims are rejected because of preventable errors like missing information, coding errors and/or sequential billing errors, etc.?

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What percentage of your claims get written off each month due to timely filing limits?

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What percentage of claims are denied due to eligibility issues, such as changes in coverage or inactive plans?

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Medicare

How many FTEs are assigned to research, correct, and rebill denied claims?

What percentage of their time is used for these activities?