Denial Rate Calculator

Your claim denial rate is the number of claims denied divided by the number submitted in a period, shown as a percentage.

What is a good denial rate?

Under 5% is generally considered healthy, and best-in-class practices run 2 to 4%. Above 10% usually points to a concentrated, fixable root cause.

How to calculate denial rate

Denial rate = (claims denied divided by claims submitted) times 100, measured over a period such as a month.

How to reduce your denial rate

Verify eligibility before the visit, secure prior authorizations, scrub coding for medical-necessity mismatches, and work denials fast while tracking root cause.