Your practice
Run the math on your practice
Choose your specialty for a starting estimate, then adjust any number to match your practice.
The AMA finds 80.7% of appealed prior-auth denials are overturned, so most of this is winnable. Praxigen targets it directly: flagging documentation gaps before submission so fewer PAs are denied, and drafting policy-grounded appeals so denials do not get dropped.
Estimate only, for illustration. Not a guarantee of results or approvals. Default assumptions are anchored to published research; specialty presets are typical starting points to adjust to your own data. Denial rates: the U.S. initial claim denial rate was ~11.8% in 2024 (Kodiak Solutions revenue-cycle data, ~2,100 hospitals and 300,000 physicians), an all-claims figure used here as a general starting proxy; for prior authorization specifically, orthopedic ASC cases commonly run 14–22% and interventional pain procedures around 20%. Per-specialty denial presets outside those are typical-range estimates, not exact figures. Most denials are never appealed (the 2024 AMA Prior Authorization Physician Survey found fewer than 1 in 5 physicians, 18%, always appeal), yet of the denials that areappealed, 80.7% were fully or partially overturned in Medicare Advantage in 2024 (KFF analysis of CMS data; only 11.5% of MA denials were appealed at all). PA volume is anchored to the AMA finding of ~39 prior authorizations per physician per week (practice totals scale with the number of providers). “Revenue at risk” = denied PAs never appealed × average procedure revenue, and excludes delayed approvals, staff time, and patient attrition. Revenue per procedure varies widely by specialty and payer, so enter your own.
Where Praxigen moves the needle
Your numbers above, against the cited national picture.
Nationally, fewer than 1 in 5 physicians always appeal a denial (AMA). Praxigen drafts the policy-grounded appeal, so far more get filed instead of written off.
Procedural specialties commonly run 14–22% (orthopedic ASC; ~20% interventional pain). The Note Checker flags documentation gaps before submission so fewer are denied.
Winnable revenue = the revenue at risk above × the 80.7% Medicare Advantage appeal-overturn rate (KFF, 2024 — the share of dropped denials that would be overturned if pursued; MA is the best national PA dataset and other markets overturn less). Directional estimate, not a guarantee.
See the full value breakdown for these numbers →And that’s only the cost of standing still. The value of fixing it is the bigger number: winnable revenue recovered, denials headed off before they happen, and your team’s hours back.