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What did you earn and not collect?
A full solo caseload is roughly 100 claims a month. At $120 allowed, that is $144,000 a year — so every single percentage point lost between the session and the payment is about $1,440 a year. Not an estimate. Multiplication.
The catch is that nobody can tell you their percentages. Your clearinghouse is paid to move the claim, not to notice that the payment came back fourteen percent light. So the money goes unmeasured, and what goes unmeasured goes uncollected.
This measures three of them from your own remits: paid below what that payer normally pays you, denied and never reworked, and gone past timely filing.
Three columns are all it needs: payer, procedure code, and what the payer actually paid. Everything else is optional and only makes the answer sharper.
Your data
Haven't got the export yet? The sample runs the real calculation on invented remits, so you can see exactly what you'd get before spending twenty minutes in your billing system.
What to export — and what to leave out
Pull a payments or remittance report out of your billing system or clearinghouse for the last twelve months, and keep only these columns. Only the first three are required.
| Column | Needed? | What it is |
|---|---|---|
| payer | required | The insurance company. A name is fine. |
| cpt | required | The procedure code you billed — 90837, 90834, and so on. |
| paid | required | What the payer actually paid on that line. Zero for a denial. |
| service month | optional | Month of service, like 2026-01. A full date works too — only the month is kept. |
| allowed | optional | The allowed amount from the remit. Without it we fall back to your own median for that code. |
| billed | optional | What you charged. Used only as a last-resort fallback. |
| denial code | optional | The CARC on denied lines. Without it, denials and timely filing can't be separated. |
| claim ref | optional | Any claim number or made-up token. Without it we can't tell a denial that was reworked from one that was abandoned, so the denial figure becomes an upper bound. |
| units | optional | Defaults to 1 if absent. |
- No patient names, initials or record numbers
- No dates of birth
- No member, subscriber, Medicare or Medicaid ID numbers
- No addresses, phone numbers or email addresses
- No diagnoses or clinical notes
Download a template CSV — fill it in or match its column names.
Doing this later? We'll email you these instructions so you don't have to find this page again.
Why we built this
We tell clinicians that a single point of claims leakage is about $1,440 a year. Then somebody asks what their own number is, and the honest answer has been that nobody knows — not them, not us, not their clearinghouse. This is the answer. If yours comes back near zero, we were wrong about your practice, and finding that out cost you one CSV export.
None of this needs us. Twelve months of your own remits, grouped by payer and procedure code, the median paid per unit, then anything under eighty percent of that median flagged — it is a pivot table. We built the page because almost nobody builds the pivot table, not because the arithmetic is hard.