Value & ROI Calculator

Model the exposure. Justify the program.

Enter a plan's figures (or keep the illustrative defaults). The model estimates the annual improper-payment and avoidable-overturn exposure InsuredAudit makes defensible, derives an indicative program investment, and shows the value-to-investment ratio.

Plan inputs

Scale

Covered members (lives)

Annual claims spend

UM determinations / year (prior-auth + reviewed claims)

Denial & appeal dynamics

Denial rate (% of determinations)

Overturn rate (% of denials overturned on appeal)

Cost per overturned denial (rework + appeal handling + abrasion)

Assumptions (tune to taste)

Improper-payment rate (% of spend; CMS cites ~5-8%)

Share InsuredAudit can address (conservative capture rate)

Platform rate (per member / month; $5M/yr floor applies)

Estimated value

Annual addressable exposure

Improper-payment leakage--

Avoidable overturn cost--

Value InsuredAudit can address / yr

at the capture rate above · non-contingent

Indicative program investment

Platform (per year)--

Managed operations (per year)$2.0M

Implementation (one-time)$5.0M

5-year total (TCV)--

value-to-investment (5-year)

This is a model, not a quote. Bring your real numbers to a no-fee scoping session and we'll validate the value against your own determinations. Request a briefing

Estimates only, for discussion. Addressable exposure is not guaranteed recovery; InsuredAudit is a detect-and-evidence platform (non-contingent), not a recovery service. Program figures are indicative and sized per engagement. See the pricing model at insuredaudit.com/pricing. Confidential.