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

Appeals you work today% of denials that get appealed at all

Overturn rate% of worked appeals overturned

Value per overturnavg 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 today

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

Pricing is per event, tiered by committed volume. We’ll quote it against these numbers in the pilot conversation rather than publish a rate card you’d have to reverse-engineer.

Get it quoted →

Every formula, stated

denials/mo = submissions × denial rate

appealed today = denials × appeals-worked rate

recovered today = appealed × overturn rate × value

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

hours reclaimed = appealed × 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.