Tools / Denial cost calculator
What do your denials cost each month?
Reworking one rejected claim costs about $118 in staff time and delay. Multiply that by your volume and rework rate and the number is usually larger than anyone has written down. Put your figures in; nothing leaves your browser.
What checking a case costs, next to reworking one
AffirmDME reads the packet and checks it against the LCD’s requirements, item by item, then lists what is missing — with the citation — before you submit. The honest comparison is per case: what one reworked claim costs you against what it costs to check one case first. The last column is the break-even — how many reworks a month an option would have to prevent to pay for itself on rework alone. It is arithmetic, not a promise about how many it would prevent; that depends on why your packets come back.
| Option | Per case | Per month | Breaks even at |
|---|---|---|---|
| Reworking one denied claim | — | — | — |
| Pay-as-you-go ($75 per case, no subscription) | $75 | — | — |
| Starter (per location, 50 cases included) | — | — | — |
| Professional (per location, 150 cases included) | — | — | — |
See what the checklist would have flagged.
The free trial workspace comes with eleven sample cases and a library of sample documents. Add one to a case and watch the real extraction and checklist run. No patient data, no card, nothing billed. Once you go live, the same sandbox takes your own de-identified packets.
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The $118 rework figure is an industry estimate for the staff time and delay of correcting and resubmitting a rejected claim; the 24-minute manual prior-authorization figure is from the CAQH Index. Plan prices mirror our published pricing. This tool does not estimate your affirmation rate.