Healthy RCM Benchmarks
These are the revenue-cycle metrics that tell you whether a practice is collecting what it earns. The targets below are widely cited industry benchmarks (MGMA/HFMA-style ranges); they vary by specialty, payer mix, and practice size, so read them as directional, not absolute. The point isn't hitting a single number — it's watching the trend and catching a warning sign before it becomes a cash problem.
| Metric | Healthy target | Warning sign |
|---|---|---|
| Net collection rate | 95–100% of contracted (allowed) amount | Below ~93% — you're leaving contracted dollars on the table |
| Days in A/R | 30–40 days | Above ~50 days, or a rising trend |
| A/R over 90 days | Under ~15–20% of total A/R | Above ~25% — aging is outrunning your workflow |
| Clean claim rate | 95%+ pass on first submission | Below ~90% — front-end errors are costing rework |
| First-pass resolution / paid rate | 90%+ paid on first submission | Below ~85% — too many claims need rework |
| Denial rate | Under ~5–10% of claims | Above ~10%, or a climbing trend |
| Cost to collect | ~2–4% of net revenue (varies widely) | Rising cost with flat or falling collections |
What to do with this
- Net collection rate is the truest health signal — it measures what you collected against what you were actually owed under contract, after legitimate write-offs.
- Watch days in A/R and the over-90 bucket together; a healthy average can still hide a growing pile of old, unworked claims.
- A high clean-claim rate with a high denial rate means the problem is on the payer/adjudication side, not your claim scrubber.
- Benchmarks vary by specialty and payer mix — compare a practice to its own trend line first, then to the industry range.
Volari works the metric that quietly erodes net collection rate: the denied and underpaid claims sitting in the over-90 bucket that no one has time to rework. Recovering them is what moves the number, not another front-end scrub.
See the revenue you're owed.
A free assessment shows your real recoverable number from denials and underpayments. No risk, paid only on what we recover.
Unlock your revenue — free estimate →