Recovery model · your numbers, not ours

What is your residual actually worth?

Put in your own volumes. Everything below is arithmetic on your inputs — no assumptions of ours are hidden in it, and every formula is stated at the bottom of the page.

Your inputs

Prior-auth submissions per month

Denial rate

of submissions that come back denied

Denials appealed now

your current baseline: share of denials that get appealed at all

Overturn rate

of worked appeals overturned

Value per overturn

average charges recovered

Staff hours per appeal

Loaded cost per hour

Assumed reduction in hands-on time

This is the one number we can't source from your data — set it to whatever you'd defend in a business case, or zero to ignore staff time entirely.

Modeled monthly picture130 denials/mo · 72 appealed at your current rate

Recovered today$343,200from the appeals your team gets to

Left on the table$280,800denials never appealed, at your own overturn rate

If every denial gets worked$624,000

$7,488,000 a year, of which $3,369,600 is revenue you are currently writing off.

Staff hours per month89 hrsreclaimed at your assumed reduction

That time, valued$4,022a month — the softer half of the case

The pilot covers 25 events - a submission, an appeal or an action plan. After it, pricing is per event on annual volume tiers, from $125 down to $86 per event. No platform fee.

Get it quoted →

Every formula, stated

denials/mo = submissions × denial rate

appealed now = denials × share of denials appealed now

recovered today = appealed now × overturn rate × value

left on the table = (denials − appealed now) × overturn rate × value

hours reclaimed = appealed now × hours × reduction

What this model does not claim

It does not assume we raise your overturn rate — the arithmetic uses yours throughout. It does not price the work. And it is a model, not a result: the only number worth signing against is the overturn rate measured on your own denials during a scoped pilot.

What is your residual actually worth?

Replace the model with a measurement.