Hospital Revenue Bleed & Rework Model
Quantify the total cost of payer-rule friction on working capital and administrative expense.
Potentially Recovered Revenue
$0
Lost: Never Resubmitted
$0
Lost: Non-Recoverable
$0
Administrative Rework Cost Burden (Range)
$0 - $0
Industry Assumptions & Benchmarks:
- Recovery Breakdown: Assumes ~60% of denied claims are ultimately recovered through administrative rework, ~18% are abandoned/never resubmitted, and ~22% are non-recoverable write-offs.
- Rework Volume: Assumes all recovered and non-recoverable claims (82% total) undergo manual administrative rework/appeals.
- Rework Cost Range: $25 (automated/standard touch) to $118 (complex clinical/administrative appeal) per reworked claim.