Denial Risk Assessment Tool

The Denial Risk Tool is a free revenue cycle assessment that scores six metrics against MGMA and HFMA benchmarks: initial denial rate, first-pass clean claim rate, days in accounts receivable, net collection rate, appeal overturn rate, and cost to collect. No account is required. No data is transmitted — all calculations run in the browser.

Enter your practice's current figures for each metric. The tool returns a color-coded score (green/yellow/red) for each input, an overall revenue cycle health score on a 100-point scale, and a dollar estimate of annual revenue at risk based on the gap between your metrics and the benchmark target. A practice billing $5M annually with a 12% denial rate and 48 days in AR typically shows $180,000–$340,000 in addressable revenue leakage.

The output includes a prioritized 90-day recovery protocol — a sequential action list ordered by expected revenue impact, starting with the highest-leverage intervention for your specific gap pattern. Denial rate gaps trigger front-end workflow and coding recommendations. AR day gaps trigger payer follow-up and appeal workflow recommendations. Collection rate gaps trigger write-off and underpayment audit recommendations.

The scoring model weights inputs against MGMA 2024 Physician Practice Benchmark Report data and HFMA MAP Key performance metrics. Specialty-adjusted targets are applied for behavioral health, radiology, emergency medicine, and other specialties with above-average prior authorization burden.

• RCM benchmarks — see the target figures used in scoring
• 90-day RCM recovery checklist
• Scoring methodology
• Cash leakage calculator