Hybrid ClaimsIQ / Interactive Financial Tools

Claims Audit ROI Calculator

Estimate the potential financial impact of professional desk reviews across your claims program. Adjust the assumptions to compare review cost, proposed reductions, and realized savings.

Program assumptions

Use your own claim figures. Example values are illustrative and do not represent a Hybrid savings guarantee or a quoted price.

Claims reviewed per month

Expected monthly audit volume

Average submitted demand ($)

Average claim estimate reviewed

Proposed adjustment (%)

Assumed reduction recommended after audit

Realization rate (%)

Share of proposed reductions actually achieved

Average audit fee ($)

Replace sample fee with your actual expected rate

Eligible claims (%)

Share of input volume sent for paid review

How the estimate is calculated

Eligible annual claims × average demand × assumed adjustment × realization rate = projected realized savings. Subtract estimated review fees to determine projected net benefit.

Your projected annual impact

Numbers update as you change the assumptions.

Projected realized savings—

Estimated annual review fees—

Projected net benefit—

Illustrative ROI—

Eligible reviews per year—

Annual submitted demand reviewed—

Proposed annual adjustments—

Net benefit per eligible review—

Illustration only. Review adjustments are not the same as collected or negotiated savings. Calculations assume a uniform claim mix and do not account for program setup, staff time, or other operating costs. Actual results vary. The ROI shown is (projected realized savings − review fees) ÷ review fees, when review fees are greater than zero.

Want a program-specific analysis?

Hybrid can discuss your claim mix, review volume, workflow and pricing to help evaluate where desk reviews may deliver value.

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