Intelligent RCM · exposure model

What is sitting in your denial inventory right now?

Six numbers most revenue cycle leaders already know. This works out what they add up to. It does not tell you what we would recover, because that number belongs to your data and not to a slider.

Estimates are fine. Nothing you enter leaves your browser, and nothing below assumes Penguin Ai is involved.

Your numbers

Estimates are fine. The model is for framing a conversation, not for a board deck.

Volume and denials
Marketplace plans denied 19% of in-network claims in 2024, with plan-level rates from 3% to 36%. Yours will differ by payer mix.
What actually gets worked
Everything above this line never gets touched before the filing window closes.
Your own rate. We apply it unchanged to the denials nobody reaches.
Cost of the work

What that adds up to

Every figure below is derived only from the inputs on the left. Nothing here assumes Penguin Ai is involved.

$15M in denied claims never worked, of which $6.1M is recoverable at your overturn rate.

Denied dollars nobody reaches
$15M
10,450 denied claims a year at $1,400 average value, never opened before the window closes.
Recoverable inside that
$6.1M
Applying your own overturn rate to the denials nobody works. This is the number that goes to zero on timely filing.
Cost per account worked
$10.71
Fully loaded staffing cost divided by the accounts your team can actually work in a year.
Denials per year
27,500
Total denied claims at your volume and denial rate.
Annual working capacity
120,960
Accounts your current team can open, at your stated pace and headcount.
Denial inventory against capacity
17,050 worked10,450 never openedCapacity covers the denial inventory. The constraint is elsewhere.
What this model refuses to calculate

A savings figure. We would have to assume a recovery rate we have not earned on your data. Every vendor at this conference will give you one. Ours would be worth exactly as much as theirs.

Faster cash. Most organizations already collect the majority inside thirty days, so speed is rarely the leak.

Revenue uplift. The only credible uplift is money currently going to zero, which is the first number on this page.

Now run it on your real data.

Sixty minutes with your denial and remittance file. We come back with what is actually in it: which categories drive the write-offs, how much is inside the filing window, and where the recoverable money sits. Findings, not a pitch. You keep them either way.

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Capacity assumes 240 working days a yearEstimates only · Not a projection of results

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