Key RCM Metrics to Track

You cannot improve what you do not measure. Tracking the right revenue cycle metrics gives your practice a clear picture of financial health and helps prioritize where to focus improvement efforts.

Days in accounts receivable

Days in A/R measures how long it takes to collect payment after a service is rendered. Industry benchmarks vary by specialty, but most practices should aim for 35 days or fewer.

How to calculate

Divide your total accounts receivable by your average daily charges. The result is your days in A/R.

A rising trend often signals slow follow-up, increasing denials, or payer processing delays.

Clean claim rate

Your clean claim rate is the percentage of claims accepted on first submission without rejection or denial. A healthy practice typically achieves 95% or higher.

Common causes of rejections

• Missing or invalid patient demographics
• Incorrect payer ID or member number
• Coding errors or mismatched diagnosis codes
• Missing prior authorization numbers

Denial rate

Track both your overall denial rate and denials by reason code. This tells you whether problems originate in eligibility, coding, authorization, or medical necessity.

Target benchmark

Most well-managed practices keep their denial rate below 5% of total claims submitted.

Net collection rate

Net collection rate measures how much of the reimbursement you are entitled to collect actually gets paid. It accounts for contractual adjustments and write-offs.

A net collection rate above 96% indicates strong billing and follow-up processes.

Putting metrics to work

Review these metrics monthly with your billing team. Look for trends rather than single data points, and assign an owner to each underperforming area. The guides in this series provide actionable steps for improving each stage of the cycle.