RCM KPI Benchmark Scorecard
Enter the figures from your own reports and get an instant grade on six core revenue cycle KPIs, each shown against the benchmark range the industry uses — so you can see exactly where money is leaking.
One number never tells the story. This scorecard takes the figures from your own practice management reports and grades six core revenue cycle KPIs at once — denial rate, first-pass rate, net collection rate, days in AR, the share of AR over 90 days, and cost to collect — each against the benchmark range used across the industry.
Grade your revenue cycle
The formulas
- Denial rate = claims denied at least once / total claims submitted.
- First-pass rate = claims paid on first submission / total claims submitted.
- Net collection rate = payments / (gross charges - contractual adjustments). This measures how much of what you were actually owed reached the bank.
- Days in AR = total AR / (annual gross charges / 365).
- AR over 90 = AR aged past 90 days / total AR.
- Cost to collect = total billing cost / total collections.
Reading your scorecard
The benchmarks are the ranges most often cited in industry guidance: HFMA points to a denial rate of 5% or less, AAFP describes 5–10% as the typical band, and MGMA reporting puts healthy days in AR in the 30–40 day range, with less than 10% of AR sitting past 90 days. Treat them as guideposts, not grades on a report card — payer mix and specialty move every one of these numbers. What matters most is the pattern: a good net collection rate beside a poor days-in-AR usually means slow follow-up rather than bad contracts, while a poor denial rate beside a good first-pass rate often points at one or two problem payers. For a deeper dive into each metric, see our guide to medical billing KPIs, or use the dedicated days in AR calculator and net collection rate calculator to trend a single number month by month.
Frequently asked questions
What is a good denial rate for a medical practice?
HFMA guidance points to 5% or less, and AAFP describes 5–10% as the range many practices actually experience; MGMA survey reporting has put the median near 8%. Above 10%, denials are almost always a process problem — eligibility, authorization, coding or timely filing — rather than bad luck.
How is this different from the single-metric calculators?
The standalone calculators trend one number in depth. This scorecard grades six KPIs side by side from one set of inputs, which is how a billing review actually starts: the pattern across metrics (for example, good net collections but poor days in AR) usually points at the root cause faster than any single figure.
Why does a KPI show a dash instead of a grade?
A dash means the KPI could not be computed because a needed input was zero or blank — for example, days in AR needs your last 12 months of gross charges. Enter that figure and re-run the scorecard to get the grade.