Monitor these essential metrics to optimize revenue cycle performance:
📊 Claims Processing Metrics
- Clean Claim Rate: Target >95%
(% of claims paid on first submission) - Denial Rate: Keep <5%
(Claims denied by payers) - Days in A/R: Goal <40 days
(Average time to get paid)
💰 Financial Performance
- Collection Rate: Aim for 95-98%
(Actual payments vs expected) - Aging A/R:
- <10% over 60 days
- <5% over 90 days
- Cost to Collect: Ideal <3-5% of revenue
(Billing admin costs)
⏱ Efficiency Indicators
- Claim Submission Lag: Target <48 hours
(Service date to billing date) - Appeal Success Rate: Goal >65%
(Overturned denials) - Payment Posting Time: <24 hours after EOB
