ANSWERS · REVENUE CYCLE

What is a good denial rate for a medical practice?

A healthy initial denial rate is under 5–10%, with a first-pass resolution rate above 90%. Many independent practices run 15–20% and write off a large share of denials unworked, so the number that matters most isn't just the denial rate — it's how much of it you actually recover.

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What actually matters

  • Under 5–10% initial denials is the benchmark; above ~15% signals front-end problems
  • First-pass resolution above 90% means your clean claims are actually clean
  • Track your denial rate and your recovery rate — a low denial rate still leaks money if denials go unworked
  • Know your denial mix; a handful of reason codes usually drive most of the volume

Common questions

How do I calculate my denial rate?

Denied claims divided by total claims submitted over a period. Track it both by count and by dollars, since a few high-value denials can outweigh many small ones.

Where Volari fits: Volari focuses on the number most practices ignore — how much of your denials you actually recover — by working the pile you'd otherwise write off.

Related answers
How do I lower my practice's denial rate? →How do I reduce days in A/R? →How do I read an EOB or 835 remittance? →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? →

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