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CHECK YOUR DENIAL APPEAL WIN PROBABILITY

Enter your denial code, insurance company, and state. Get an instant score with insider intelligence on your chances of winning — built by someone who spent 20 years on the other side.

Based on CMS data, 200+ payer behavior patterns, and 50-state regulatory analysis

Score My Denial ↓

Denial Score Calculator

Answer 4 questions. Get your score in under 60 seconds.

Find this on your Explanation of Benefits (EOB) or denial letter. Look up denial codes →

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Denial Score
⚠ Insider Tip

How the Denial Score Works

01

Denial Code

Your CARC code reveals the insurer's stated reason. Each code has a known appeal success rate based on CMS data and industry patterns.

02

Payer Behavior

Every insurer has different denial patterns, appeal review processes, and internal vulnerabilities. We've mapped 200+ behavior patterns across 12 major payers.

03

State Regulation

Your state's insurance laws dramatically affect your leverage. Some states have "deemed approved" rules, others have aggressive enforcement that scares payers.

04

Service Type

Surgery denials appeal differently than medication denials. The evidence you need and the regulatory leverage you have varies by category.

Denial Code Win Rates

Average appeal success rates for the most common denial codes. Your actual score depends on payer, state, and service type.

Built on Real Data

200+
Payer behavior patterns mapped
50+DC
State regulatory profiles analyzed
20 YRS
Health system insider experience

Frequently Asked Questions

What is a Denial Score?
A Denial Score is a 0–100 probability estimate of your chances of winning an insurance denial appeal. It combines the denial reason code (CARC), payer behavior patterns, your state's regulatory environment, and the type of service to generate a personalized win probability. Higher scores mean stronger appeal chances.
How accurate is the Denial Score?
The score is based on CMS public data, state regulatory databases, and 20 years of insider health system experience analyzing denial patterns across 12 major payers. It reflects aggregate win rates and payer-specific behavioral patterns. Your individual outcome depends on the quality of your appeal, your specific clinical documentation, and the evidence you submit.
Is this tool really free?
Yes. You get your denial score, win probability, 4 key insights, and an insider tip completely free — no account required. For a detailed appeal strategy with state-specific regulatory leverage, evidence checklists, and payer-specific tactics, enter your email to unlock the full report (also free). We'll also add you to Denial Dispatch, our free weekly insider newsletter.
Where do I find my denial code?
Your denial code (called a CARC — Claim Adjustment Reason Code) appears on your Explanation of Benefits (EOB) letter from your insurance company, or on the denial notification itself. It's usually formatted like "CO-50" or "PR-1". If you can't find it, select "Other / I don't know my code" and we'll still give you a score based on your payer and state.
What should I do after getting my score?
Unlock the full strategy report (free with email), then follow the recommended next steps. For high scores (70+), you can likely win this yourself — our DenialBot tool generates appeal letters. For moderate scores (40-70), our Denial Decoder MicroCourse teaches the exact insider strategies. For complex cases (below 40), expert help from someone who knows payer behavior inside-out may be your best path.
Can I use this for a denied surgery?
Absolutely. Surgical denials are actually one of the strongest categories for appeals. We track denial patterns for 76 surgical CPT codes across 20+ specialties. Select "Surgery / Surgical procedure" as your service type to get surgery-specific insights including relevant NCCI bundling issues and medical necessity evidence requirements.

Don't Let Your Denial Win

Over 80% of properly filed appeals succeed. Fewer than 1% of patients ever appeal. Be the 1%.

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