Infusion Revenue Leakage Calculator

Follow a month of infusion visits from the schedule to the bank and see which step loses the most money.

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One month of visits

Every infusion visit on the schedule, before no-shows and cancels.

Visits where the patient was treated. The rest were no-shows, cancels, or moved.

What you expect to be paid for one visit, drug and administration together, from the payer and the patient.

Billing and payment

Your own target for getting a completed visit documented and billed.

Documented and billed within the days above.

Paid on the first submission, with no denial or resubmission.

Denials that are fixed, appealed, or resubmitted and then paid.

Example values. Replace them with yours.

$141,336 of $720,000 did not reach the bank this month. Biggest leak: Visits that did not happen.

Did not reach the bank this month

$141,336

20% of the $720,000 on the schedule

Lost at each step

  • Visits that did not happen$72,000

    60 visits

  • Visits not billed within 7 days$32,400

    27 visits

  • Denied claims never recovered$36,936

    31 visits

Scheduled, at expected payment
$720,000
Deposited this month
$578,664
Denied, then recovered
$55,404
Lost at this rate for a year
$1,696,032

Biggest leak: Visits that did not happen. Start there.

A planning estimate, not a forecast. Every visit is valued at the same average payment, and recovered denials count as paid this month. Free, and nothing you enter is sent anywhere.

How to use it
  1. Enter one month of scheduled visits, the share completed, and your average expected payment per visit.
  2. Enter your billing window, the share billed in that time, the share paid the first time, and the share of denials you recover.
  3. Read the dollars lost at each step, the total that did not reach the bank, and the biggest leak to start on.
How the numbers work
  • On the schedule = scheduled visits × average expected payment
  • Visits that did not happen = scheduled × (1 − share completed)
  • Visits not billed in time = completed × (1 − share billed in time)
  • Denied = billed × (1 − share paid the first time)
  • Denied claims never recovered = denied × (1 − share recovered)
  • Dollars lost at each step = visits lost at that step × average expected payment
  • Deposited = (paid the first time + recovered) × average expected payment

With the example values: 600 visits × $1,200 = $720,000 on the schedule. 60 visits did not happen ($72,000). Of 540 completed, 27 were not billed within 7 days ($32,400). Of 513 billed, 76.95 were denied and 30.78 never recovered ($36,936). Total: $141,336, and the biggest leak is visits that did not happen.

Before you trust the result
  • Some missed visits come back. A visit moved to next week is not lost, but the chair time this week is. Check how many no-shows and cancels are rebooked.
  • Late is not the same as never. Visits billed late are missing from this month's deposits. Follow them for a few months to see how many are paid and how many miss the filing deadline.
  • Averages hide expensive drugs. One denied claim for a high-cost drug can outweigh dozens of small ones. Run the same walk for your top drugs on their own.
  • Partial payments are not in here. A claim paid below the expected amount leaks too. This walk only counts visits that were not paid at all.
Questions

What is revenue leakage at an infusion center?

It is money you expected from a scheduled visit that never reaches the bank: the visit did not happen, it was not billed in time, or the claim was denied and never recovered. This calculator walks one month through those three steps.

Is a visit billed late really lost?

Not always. A late claim is money missing from this month's deposits, and the later it goes out, the more likely it is to miss a payer's filing deadline or never be billed at all. Treat this step as money at risk and check how much of it is eventually paid.

Where do I get these numbers?

Scheduled and completed visits come from your appointment list for the month. Days to bill comes from the date of the visit and the date the claim went out. First-time payment and recovered denials come from your billing system or your billing company's reports. If billing runs in WeInfuse, start from completed appointments and the claims tied to them, and check a few days by hand before trusting the totals.

How do you calculate infusion revenue leakage?

Value the month's scheduled visits at your average expected payment, then take out visits that did not happen, completed visits not billed in time, and denied claims never recovered. Each step's dollars are the visits lost there times the average payment, and what is left is the money deposited.

Which step should I fix first?

Start with the step that loses the most dollars, which the calculator names as the biggest leak. Then run the same walk for your highest-cost drugs on their own, because one denied claim for an expensive drug can outweigh dozens of small ones.

Does this include underpayments?

No. A claim paid below the expected amount leaks too, but this walk only counts visits that were not paid at all. Compare paid amounts with your contracted rates to find underpayments.

Where the definitions come from

For the ten handoffs where revenue slips, see where infusion centers lose revenue between order and deposit, and for each term, the infusion center KPI glossary. More on pulling visits and claims out of WeInfuse in the WeInfuse reporting guide.

Infusion center KPI glossaryWeInfuse reporting guideTalk to Greyfield Data

Educational estimate only. WeInfuse is a trademark of its owner. Greyfield Data is independent and not affiliated with WeInfuse.

Related tools

Want this from your own data?

Your schedule, claims, and payments already hold this walk for every visit, by site, payer, and drug. We build the monthly report, with the list of visits still waiting to be billed or paid.

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