Should I count first-pass denials only?

Yes. The MGMA-standard denial rate is first-pass denials ÷ submitted claims. Including subsequent-pass denials inflates the number and is not comparable to published benchmarks.

Why is recoverable share fixed at 65%?

It is the median across the Medonix client base. The actual share depends heavily on the dominant CARC mix in your denials. CO-16 (information missing) recovers near 85%; CO-50 (medical necessity) recovers near 35%; CO-97 (bundled) is mostly write-off.

How fast can a denial rate be reduced?

90 days for most practices. The fastest gains come from upfront eligibility verification (eliminates CO-27 entirely) and prior-authorization workflow (eliminates CO-15 and CO-197). Coding-driven denials take longer because they require chart-level remediation.

Free tool

Denial Rate Calculator

Name: Medonix MSO
Address: 300 Delaware Ave Suite 210, Wilmington, DE, 19801, US
Telephone: +1-302-520-5413
Price range: $$

Benchmark your denial rate against your specialty. This calculator is free, requires no signup, and runs entirely in your browser. Medonix never receives your inputs unless you opt in to receive a personalized report by email.

Result

Denial rate

9.0%

MGMA best-quartile: ≤5%. Median: ~7%.

Recoverable (est.)

$26.0k

Approx. 65% of denials are recoverable through appeals + corrections.

At-risk write-off

$14.0k

The ~35% that becomes hard write-off without intervention.

Annual denied $

$479.5k

Denied claim value across 12 months at this rate.

Elevated. CO-16 and CO-50 categories are likely driving avoidable rework.

Methodology

Denial rate: denied claims ÷ submitted claims, expressed as a percentage. Compared against the MGMA cost-survey distribution.

Recoverable share: 65% benchmark drawn from MGMA / HFMA published denial-recovery studies, cross-referenced with anonymized first-pass denials from Medonix's founding client cohort. Recovery probability is highest for CO-16 (information missing), lowest for CO-50 (medical necessity).

Frequently asked

About the Denial Rate Calculator.

MGMA reports a best-quartile cutoff at ≤5% and a median around 7%. Above 12% suggests systemic issues in eligibility, prior authorization, or coding. Different specialties run higher (oncology, complex cardiology) or lower (dermatology, primary care).

Talk to RCM

Ready to recover every dollar your practice earns?

See your projected revenue lift in 60 seconds, or talk to a senior RCM strategist now. No commitment. Same-day slots available.

30-day parallel-run guarantee
Targets written into the contract
HIPAA · SOC 2 Type II · HITRUST

Get a free audit +1-302-520-5413

24/7 · U.S. healthcare only

Denial Rate Calculator

About the Denial Rate Calculator.

01What is a healthy denial rate?

02Should I count first-pass denials only?

03Why is recoverable share fixed at 65%?

04How fast can a denial rate be reduced?

Ready to recover every dollar your practice earns?