Denial rate calculator
Calculate your denial rate from the number of claims denied and the number of claims submitted or adjudicated.
Updated
Enter your own claim figures to calculate your denial rate — the share of claims a payer refused to pay, in whole or in part, after adjudication.
Claims the payer refused to pay after adjudication. A rejection that never reached adjudication is not a denial.
Your chosen denominator, over the same period. Conventions vary — see the assumptions below.
Enter your figures to see the result and a breakdown.
How it’s calculated
Claims denied ÷ Claims submitted (or adjudicated) × 100
Denominator and value conventions vary (submitted vs. adjudicated; claim count vs. charge value). Pick one and apply it consistently so the trend is comparable.
What this assumes
- Denominator and value conventions vary — submitted vs. adjudicated, and claim count vs. charge value. This calculator does not pick one for you: it divides the first figure by the second, whichever convention you apply.
- Apply the same convention every time, or the trend is not comparable. Both figures must cover the same period.
- The result is the arithmetic on the numbers you entered. It is not compared to a benchmark, because healthy ranges vary widely by specialty and payer — and the mix of denial reasons is usually more actionable than the headline percentage.
How to read the result
A lower denial rate generally means less rework and faster, more complete collection. Healthy ranges vary widely by specialty and payer, so read the rate as a trend and drill into denial reasons rather than comparing to a fixed benchmark — treat any published average as directional, not absolute.
Read the full denial rate definition