Write-off threshold
Below what balance does chasing cost more than the balance is worth? Four numbers you already know, against the published $57.23 per denied claim. It will not tell you to write anything off — it tells you where the hour stops being worth spending.
cost of chasing ÷ chance it pays$104.05
Below $104.05 the expected recovery does not cover the labour, on your own numbers. That is not an instruction to write those balances off — it is where to stop spending the hour, so the hour goes to the balance at 110 days instead. The commonest mistake is not chasing small balances; it is chasing them with the time the large ones needed.
Where the published figure comes from
$57.23 per denied claim in administrative cost to adjudicate a denied claim. Source. It is somebody else’s measurement of a denied claim rather than of a small patient balance, which is why the toggle above lets you use your own arithmetic instead — and why the two numbers differ.
What the threshold is not
- It is not per claim. Ten $30 balances from the same payer with the same root cause are one phone call, not ten — batch before you decide.
- It ignores the second-order effect. A balance written off quietly is a balance the payer learns it can deny, and a denial pattern nobody works is one that recurs. The cheapest fix is upstream. What each code means and how to stop it.
- It says nothing about patient balances specifically. Those carry statement costs, collection rules and a relationship, none of which are in this arithmetic.
Why almost nobody publishes this
Because the honest version of it says out loud that some balances should not be chased, and a billing company selling recovery would rather not put that sentence on its own website. It is still the most useful piece of arithmetic a small practice can do in five minutes.
The mistake it catches is not chasing small balances. It is chasing them with the hours the large ones needed. A worklist sorted by age puts a $14 copay above a $900 surgical balance at 110 days, and the person working it has no way to see the trade they are making. A threshold gives them one.
Questions
At what dollar amount should a practice stop chasing a balance?
There is no universal figure, which is why this is a calculator rather than a number. It is the cost of chasing divided by the chance it pays: at twelve minutes of a $28-an-hour person, twice, with a 55% success rate, the break-even is about $20. Change any of those and it moves. What is universal is the shape — below the threshold the expected recovery does not cover the labour.
Is it legal to write off a small patient balance?
It depends what kind of balance it is, and this is where a calculator stops being useful. Routinely forgiving Medicare cost-sharing raises issues under federal law, some payer contracts require pursuit of patient responsibility, and state rules differ. Use the figure to decide where the hours go and take advice before it becomes a written policy.
How much does it cost to chase a claim?
Premier’s published figure is $57.23 in administrative cost to adjudicate a denied claim, cited on the page. For a small patient balance your own arithmetic is usually more honest — minutes times loaded hourly cost times attempts — which is why the tool computes both and lets you pick.
Does this store my numbers?
No. Nothing is transmitted and nothing is saved; the arithmetic runs in your browser. Do not type patient information into it — it does not ask for any.
The balances above the line still need somebody
That is the queue a seat works: full time, on your hours, inside your own system, sorted by what is recoverable rather than by what is oldest. Send ninety days of aged AR and you get back what is actually recoverable in it, in writing, free.
Nothing you typed into the tool above is attached to this. This form sends the three fields in it and which page it came from — that is all it can send. Or write to ops@softhomeglobal.com and skip the form entirely. What happens to it.
Next step
Twenty minutes is enough to tell whether this fits
If it does not, I will say so. There is no sequence and nobody chases you.
Or write to ops@softhomeglobal.com