Revenue Cycle Health Check: see the dollar cost of every billing gap
Enter seven numbers from your billing report. This page scores your first-pass acceptance, denial rate, days in A/R and net collection rate against published industry bands, and shows the arithmetic behind every dollar figure.
Enter your numbers, get the gap in dollars
Use the same figures your practice management system already reports. Leave a field blank until you have it.
What your numbers say, ranked by what it costs you
Each gap below carries the arithmetic that produced its dollar figure, so you can check it against your own report instead of taking our word for it.
Where each number comes from, and what it actually measures
Every field on the worksheet is a standard report in any practice management system. If your system will not surface one of them, that is worth knowing on its own.
First-pass acceptance rate
How much of your work reaches a payer without being rejected or denied. This is a front-end number: it moves when registration, eligibility and coding are clean, and it barely moves when they are not.
Pull it from: the claims summary report, first submission only. Exclude resubmissions or the number flatters itself.Denial rate
The share of your claims a payer refused to pay as billed. Initial denials, not final ones, because the appeal outcome is a separate process with its own cost.
Pull it from: the denial report for the period. Count a claim once, even if it carries several denial codes.Days in A/R
The average number of days a dollar sits uncollected. Use gross charges, not net revenue. The corporate version of this formula divides by net revenue and multiplies by 365, which produces a number that looks better than reality and cannot be compared against any published benchmark.
Pull it from: the A/R aging summary for the outstanding balance, and the charge summary for gross charges.Net collection rate
Of the money you were actually entitled to after your contracts, how much did you collect. This is the hardest number to move and the hardest one to fake, which is why it is the first question worth asking about any billing operation.
Pull it from: payments posted and contractual adjustments for the period, against gross charges.The bands this page scores against
We did not invent these. They are the figures the industry publishes, and they are named here so you can check them.
| Metric | Top quartile | Industry median | Needs attention | Target used for the dollar figure |
|---|---|---|---|---|
| First-pass acceptance | 98% and above | 94% | Below 90% | 95%, the floor of the HFMA clean-claim target |
| Denial rate | Below 5% | 11.8% | Above 12% | 5%, the HFMA top-quartile threshold |
| Days in A/R | Under 30 days | 38 days | Above 45 days | 35 days, the HFMA best-practice line |
| Net collection rate | 96% and above | 87.4% | Below 88% | 96%, the MGMA standard |
Sources. HFMA publishes a clean-claim target of 95 to 98 percent on first submission, a top-quartile denial rate below 5 percent, a days-in-A/R target range of 30 to 40 days with best practice under 35, and a top-quartile net collection target of 96 percent or above. MGMA DataDive reports a median net collection rate near 93 percent and a standard of 96 percent, and its 2024 Cost and Revenue Survey puts median days in A/R at 47 with better performers at 36. The industry first-pass denial rate of 9 to 12 percent is the most widely referenced figure in US revenue-cycle reporting, and the 2026 all-specialty medians quoted above (38.2 days, 94.1 percent clean claim, 11.8 percent denial, 87.4 percent net collection) come from published 2026 benchmark reporting.
What these are not. They are directional reference ranges, not targets set by us and not a substitute for your own payer contracts. Specialty and payer mix move every one of them. Where a published specialty figure exists it is shown in the table below; the calibration board itself uses the all-specialty band.
| Specialty | Days in A/R | Denial rate | First-pass | Net collection | Our page |
|---|---|---|---|---|---|
| Primary care and family medicine | 28.3 | 8.9% | 96.1% | 90.4% | Family medicine |
| Orthopedics | 34.1 | 10.3% | 95.4% | 89.6% | Orthopedics |
| Radiology | 36.8 | 15.6% | 92.4% | 86.1% | Radiology |
| Cardiology | 39.4 | 12.7% | 93.5% | 88.2% | Cardiology |
| Behavioral health | 42.6 | 14.2% | 91.8% | 84.9% | Mental health |
| Oncology | 45.2 | 13.8% | 93.0% | 87.5% | Oncology |
Published 2026 specialty medians, normalized for payer mix and practice size. Where a specialty is not listed, no published figure was available and we would rather say so than estimate one. We bill for 40 specialties; the full list is on the specialties hub.
What to fix, in the order that pays back fastest
These three run in order because each one makes the next cheaper. A cleaner front end means fewer denials to work, and fewer denials means a shorter A/R.
Stop the claims that never should have been denied
Eligibility verification before the visit, and a scrub against payer-specific rules before submission. Every claim that fails first pass adds roughly 15 to 30 days to its own collection cycle before anyone touches it again.
Eligibility verificationWork the denials you already have
HFMA estimates 65 percent of denied claims are never appealed, and where they are appealed the published overturn rate runs above half. Unworked denials are the single largest recoverable balance in most practices.
Denial managementThen shorten the tail
Once the front end is clean and the denials are worked, what is left in A/R is aging rather than stuck. That is when a follow-up cadence by payer and by balance size starts moving the days-in-A/R number.
A/R managementGet a free assessment that goes deeper than averages
Our free billing assessment audits your real claims, not self-reported averages. You get denial reasons by payer, aging by bucket, coding accuracy findings and a written action plan with the dollar impact on each finding.
Starting price, percent of monthly collections
- No setup fees
- No long-term contracts
- Month-to-month agreement
- Includes dedicated account manager
- Includes reporting dashboards
Questions about this tool
Practical answers about privacy, benchmarks, accuracy and how to use the result.
Want a second opinion on your numbers?
Bring the result to a free assessment. We audit your real claims, not your averages, and show you exactly where revenue is leaving your practice.
Schedule a free assessmentFind out what your last 90 days of claims actually cost you
A free assessment audits your real claims, not your self-reported averages. Denial reasons by payer, aging by bucket, coding accuracy, and a written action plan with the dollar impact on each finding.
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