Calculator
How much are un-appealed denials costing you?
Denied claims are revenue you already earned. Most of them are never appealed — not because they are unwinnable, but because appealing costs half an hour of skilled staff time each.
Left on the table each year
$94,884
The difference between what you recover from the denials you appeal today and what the same overturn rate would return if every denial were appealed. It is an upper bound, not a forecast.
Undeny costs $1,188 a year — about 80× less than the gap above.
- Claims denied per month
- 152
- Denied dollars per year
- $328,320
- Recovered today, per year
- $16,744
- Gap per month
- $7,907
Defaults come from KFF’s analysis of HealthCare.gov marketplace plans in 2024, where insurers denied 19% of in-network claims and upheld 66% of the denials consumers appealed. That data describes marketplace plans and consumer-filed appeals — not every payer, and not a practice’s own book of business. Replace the defaults with your own figures wherever you have them.
Where these numbers come from
- 19%
- of in-network claims denied by HealthCare.gov insurers in 2024, ranging from 3% to 36% by insurer.
- <1%
- of denied claims were appealed by consumers — fewer than 263,000 appeals against roughly 85 million denied in-network claims.
- 34%
- of appealed denials were overturned; insurers upheld the other 66%.
All three figures come from KFF’s analysis of ACA Marketplace plans in 2024. Two caveats worth stating plainly: the data covers HealthCare.gov marketplace plans, not Medicare, Medicaid or commercial group coverage; and the appeal figures describe appeals filed by consumers, not by practices. That is why the calculator asks for your own appeal rate instead of assuming the consumer figure applies to you.
Common questions
- How much do practices lose to un-appealed denials?
- It depends on claim volume, average claim value, and how many denials go unappealed. The arithmetic is straightforward: denied claims multiplied by the share you never appeal, multiplied by the rate at which appeals succeed. For most small practices the annual figure runs to tens of thousands of dollars, which is why the calculator asks for your numbers rather than quoting an average.
- What share of claims get denied?
- KFF found that insurers on HealthCare.gov denied 19% of in-network claims in 2024, with rates ranging from 3% to 36% depending on the insurer. That figure covers ACA marketplace plans specifically, so treat it as a starting point rather than your rate — if you track your own denial rate, use it.
- How often do appeals actually succeed?
- In KFF's 2024 data, insurers upheld 66% of the denials consumers appealed — meaning roughly 34% were overturned. That is consumer-filed appeals on marketplace plans. A practice appealing with the claim record and the payer's own criteria in hand is working from a stronger position than a patient with an explanation of benefits.
- Why do so few denials get appealed?
- Because appealing takes skilled staff time — commonly 30 to 60 minutes per appeal — and a denial worth a few hundred dollars rarely feels worth an hour of the billing manager's day. That calculation is rational claim by claim, and expensive in aggregate.
Close the gap one denial at a time
Undeny turns a 30-minute appeal into a 3-minute one. Upload the denial, get the letter, track the deadline, and log every dollar that comes back.