ANSWERS · PRACTICE FINANCE

What does it cost to rework a denied claim?

Reworking a denied claim by hand is commonly estimated at roughly $25 to $118 in staff time, depending on complexity and how many touches it takes. That per-claim cost — not the merits — is what decides whether a denial gets worked, and it's why small-dollar denials get written off even when they're winnable.

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What actually matters

  • Common industry estimates put manual denial rework at about $25–$118 per claim
  • The cost is mostly labor: identifying the reason, gathering records, drafting, submitting, and following up — often multiple touches
  • Complex denials (medical necessity, appeals with records) sit at the high end; simple corrections at the low end
  • When rework cost exceeds the claim value, the denial gets written off — a cost problem masquerading as an economics-of-appeal problem
  • Lowering per-claim cost is the lever that turns the write-off pile back into recoverable revenue

Common questions

Why is reworking a denial so expensive?

It's labor-intensive and often takes several touches — reading the remittance, pulling records, drafting the appeal, submitting through the right channel, and following up. Each touch is staff time, which is why a small denial can cost more to work than it returns.

Where Volari fits: Volari attacks the cost side directly: by working denials at machine cost, the claims that were too small to be worth reworking by hand become worth recovering — and you only pay on what comes back.

Related answers
How do I lower my practice's denial rate?How do I reduce days in A/R?How do I know if I'm being underpaid by insurers?In-house billing vs. outsourcing: which is right for my practice?How do I renegotiate payer contracts for better rates?How do I fix my prior-authorization workflow?

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