What does this revenue leakage calculator estimate?
This revenue leakage calculator estimates two numbers: the revenue at risk each year from patients who slip through the gaps in your care journey, and the revenue you could recover by bringing some of those patients back. It is a sizing tool, meant to help you decide whether leakage is worth measuring properly.
Revenue leakage is care your practice planned for that never happened: a referral never scheduled, a procedure ordered but never performed, a recall that passed its due date, a cancellation never rebooked. It is different from revenue cycle loss, which happens after care is delivered. The guide to healthcare revenue leakage explains the difference in detail.
How is the estimate calculated?
The calculator uses four inputs and four steps:
- Opportunities = patients seen per year × % of patients who slip through
- Revenue at risk = opportunities × average value per visit or procedure
- Visits brought back = opportunities × % you bring back
- Recovered revenue = visits brought back × average value per visit or procedure
Nothing else is added. There are no hidden multipliers, benchmarks or industry averages in the math.
How do you find each input in your own data?
Patients seen per year
Use unique patients with a completed visit or procedure in the last 12 months. Most EHR and practice management systems can report this by location. Use unique patients, not total visits, so a patient seen six times counts once.
Average value per visit or procedure
Use the average amount you actually collect, not your charge. Your revenue cycle team can pull average payment per visit and per procedure from remittance data. If leakage in your practice is mostly procedures, use a procedure-weighted figure; if it is mostly follow-up visits, use a visit figure. When in doubt, choose the lower number.
% of patients who slip through
This is the share of patients who reach a trigger, such as a referral, order, recall or cancellation, and do not complete the next step in a reasonable window. If you have never measured it, start with one stage you can count:
- Procedures: open orders past their window ÷ orders placed.
- Recalls: recalls past due with nothing booked ÷ recalls due.
- Referrals: referrals not seen within your window ÷ referrals received.
- Cancellations: canceled appointments not rebooked within 14 days ÷ cancellations.
Use the lowest figure you find if you are unsure. You can refine it later.
% you bring back
This is the share of slipped patients your team could realistically get back on the schedule and seen. It depends on staffing, how early patients are found and how clean the list is. Start conservatively.
A worked illustrative example
The numbers below are illustrative round figures, not benchmarks.
| Input | Illustrative value |
|---|---|
| Patients seen per year | 20,000 |
| Average value per visit or procedure | $400 |
| % of patients who slip through | 10% |
| % you bring back | 25% |
- Opportunities = 20,000 × 10% = 2,000
- Revenue at risk = 2,000 × $400 = $800,000
- Visits brought back = 2,000 × 25% = 500
- Recovered revenue = 500 × $400 = $200,000
In this example, the practice has an estimated $800,000 in annual revenue at risk and an estimated $200,000 in potential recovered revenue.
What are the limitations of this estimate?
This is an illustrative estimate, not a guarantee. It is useful for sizing, not forecasting. Keep these limits in mind:
- It uses one average value. Real leakage mixes high-value procedures with lower-value visits. A blended average can hide where the value sits.
- It treats slip-through as one rate. Referrals, procedures and recalls leak at different rates. Measuring each stage separately gives a more accurate picture.
- Recovered revenue is not collected revenue. Patients brought back still go through billing. Some services will be paid less than average, and some patients would have returned on their own.
- Platform costs are not included. The recovered figure does not subtract staff time, software or other costs.
- It is not clinical guidance. Whether a patient should be brought back is a clinical decision.
For a firmer number, build a baseline from about two years of history, stage by stage, as described in the baseline metrics guide for COOs.
What should you do with the result?
If the number is large enough to matter, the next step is finding out which patients make it up. Start with the stage you suspect is largest. The guides on referral leakage, patient recall management and procedure leakage walk through each one. To see how Nuvory finds and ranks these patients from your EHR data, visit revenue leakage intelligence or see how it works.
Frequently asked questions
How accurate is the revenue leakage calculator?
It is as accurate as its inputs, and it simplifies. It uses one average value and one slip-through rate across all stages. Treat the result as an illustrative estimate, not a guarantee, and measure each stage separately for a firmer number.
Does the recovered revenue figure include software or staff costs?
No. Platform costs, staff time and other expenses are not included. The figure is estimated value of care completed, before costs.
Where do I find the percentage of patients who slip through?
Start with one stage you can count, such as open procedure orders past their window divided by orders placed. If you are unsure, use a low figure as an example and refine it once you measure.
Is revenue leakage the same as denied claims?
No. Denials are revenue cycle loss and happen after care is delivered. Revenue leakage is care that never happened, so there is no claim to deny.
What value per visit should I use?
Use the average amount you actually collect per visit or procedure from remittance data, not your charge. If you are unsure, choose the lower figure.