Remedi · 60-second estimate

Four out of five appealed denials get overturned. Nine in ten are never appealed.

That gap is money your practice already earned. Move the sliders to match your provider roster and we'll show you roughly what it's worth in a year.

Every figure on this page is from KFF, the AMA, or Premier Inc. Sources are listed below, with years.

Step 1 · Your practice type

Pick the closest match. This sets the provider types and the starting volumes.

Step 2 · Your provider roster

One notch per provider. Count anyone who bills under their own name.

Recoverable every year

Add your providers above to see the number

Where the money is

Source	Per year

The numbers this is built on

Published industry data. None of it is a Remedi claim about Remedi.

80.7% of appealed prior-authorization denials are overturned — partially or fully. KFF, Medicare Advantage 2024 data

11.5% of denied prior authorizations are ever appealed. The other 88.5% are abandoned — rescheduled, downgraded, or the patient goes elsewhere. KFF, Medicare Advantage 2024 data

7.7% of prior authorization requests are denied in full or in part, out of 52.8 million determinations. KFF, Medicare Advantage 2024 data

40 prior authorizations per physician, per week — consuming 13 hours of physician and staff time. AMA, 2025 Prior Authorization Physician Survey

~70% of denied claims are ultimately overturned and paid — after an average of three rounds of review, each taking 45 to 60 days. Roughly 15% of claims are denied on first submission. Premier Inc., 2023 claims · 280 hospitals, 23 states

$57 average cost to contest a single denied claim — $57.23, up from $43.84 the year before. Premier Inc., 2023 claims

Read those first two together. Appeals work four times out of five — and nine in ten never happen. The problem was never that appeals lose. It's that appealing costs more than most practices can justify spending, so most denials are simply written off.

How the estimate is calculated, and what to change

Prior authorizations: your monthly volume per provider × your provider count × 12 months × 7.7% denied × the increase in the share you appeal (what you'd appeal with Remedi, minus the 11.5% appealed today) × 80.7% overturned × average collected per procedure × the share of abandoned authorizations that are permanently lost.

Denied claims: your monthly denials per provider × your provider count × 12 months × the share never appealed × 70% eventual overturn rate × average collected per claim.

Cost of contesting: every denied prior authorization plus every claim denial × $57.23 each — i.e. what contesting all of them would cost, not what you spend today. A number we are quoting, not a saving we are promising.

Dollar figures are collected (allowed) amounts, not gross charges. A practice banks what it collects, not what it bills, and using charges would inflate every line on this page.

Assumptions — ours, not published data

Share of denials you'd appeal with RemediToday the industry appeals 11.5%

Claim denials never appealed todayDeliberately conservative — consumer rates are under 1%

Abandoned authorizations that are permanently lostThe rest get rescheduled, downgraded, or done anyway

Every field is editable — put your real numbers in and the estimate updates instantly. Defaults are the published figures above, not your billing data.

Sources

KFF — Medicare Advantage Insurers Made Nearly 53 Million Prior Authorization Determinations in 2024. 52.8M determinations; 7.7% denied in full or part; 11.5% of denials appealed; 80.7% of appeals overturned.
AMA — 2025 Prior Authorization Physician Survey. 40 prior authorizations per physician per week; 13 hours of physician and staff time per week.
Premier Inc. — Claims adjudication costs providers $25.7 billion. 2023 claims from 280 hospitals across 23 states. ~15% of claims initially denied; ~70% ultimately overturned; $57.23 average cost to contest.
KFF — Claims Denials and Appeals in ACA Marketplace Plans in 2024. 19% of in-network claims denied; under 1% appealed by consumers.

One honest caveat. The prior-authorization figures are Medicare Advantage specific — that is the best public data available, because CMS requires insurers to report it. No comparable dataset exists for commercial plans. Your payer mix will differ from Medicare Advantage, so treat this as a directional estimate, not a forecast.

Want your real number?

Get in touch and we'll sharpen this estimate against your payer mix, your specialties, and how you handle appeals today. No charge, no obligation.

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A directional estimate built on published industry benchmarks — not a guarantee of results. Outcomes vary with payer mix, specialty, and current appeal workflow. No patient information is involved: nothing you enter here is transmitted or stored.