How we measure
No results yet. Here is how we will measure
Each number we will report, how it is calculated, and what published industry data says, with dates. We have no client data yet.
Read this first
Industry figures come from different organizations, years and definitions. In MGMA's 2020 data, multispecialty groups had a median of 35.5 days in accounts receivable (A/R) on gross charges;1 physician-owned multispecialty groups had 60.31 days on adjusted charges.2 Different populations and bases give very different numbers, so we show who was measured, when and on what basis. For physical therapy, we found no neutral public benchmark on these measures.3,4
Each number we will report
How each number is calculated, what published data says about it, and what we have measured for our practices so far.
| Metric | How it is calculated | What published data says | Measured for our practices |
|---|---|---|---|
| Coverage checked before the visit | Share of scheduled visits whose insurance coverage was checked electronically before the visit. A coverage check is not a guarantee of payment. | In a January 2026 poll of medical practice leaders, 23% named front-end problems their biggest revenue leak.5 | No client data yet |
| Authorization and recertification warnings | Share of tracked authorizations and plans of care that got a warning to your front desk before they ran out. Your front desk still requests authorizations. | Medicare Advantage plans must decide standard prior authorization requests within 7 calendar days (rule, from 2026).6 | No client data yet |
| Signed note to claim sent | Business days from your clinician signing the visit note to the claim being sent, for every visit. The clock pauses while we wait on your practice. | MGMA advises clinicians to close notes within 72 hours and staff to post charges within 2 days (guidance, 2026).7 | No client data yet |
| Rejected claim fixed and resent | Business days from a clearinghouse or payer rejection to the corrected claim being sent. | Medicare claims must be filed within one calendar year of the date of service (rule).8 | No client data yet |
| Clean claim rateReported monthly | Claims accepted on first submission, with no clearinghouse or insurance company rejection, divided by claims first sent in the month. Corrected claims are not counted as first submissions. | No neutral public figure found. | No client data yet |
| Payment posting | Business days from an electronic remittance arriving, or a paper check reaching us, to the payment being posted and matched to its visits. | Manual remittance handling costs provider staff $5.67 against $2.95 electronic (2023 data).9 | No client data yet |
| Net collection rateReported monthly | Money collected on a month's visits, minus refunds, divided by what was expected on those visits (what payers allowed), once the visits are old enough to have settled. The report shows it for visits three months back. | Median adjusted fee-for-service collection 97.3% (multispecialty groups, 2020 data). Multispecialty medical groups; no free public figure by specialty for most specialties; MGMA's specialty breakouts are subscriber-only.1 | No client data yet |
| Unpaid claim follow-up | Business days past a claim's expected payment date before it gets a status check, and the interval between rechecks. | Medicare must pay or deny a clean claim within 30 days (rule).10 | No client data yet |
| Time to act on a denial | Business days from a denial arriving to a corrected claim, an appeal, a records request to your practice, or a written write-off recommendation. | Medicare Advantage reconsiderations are due within 60 calendar days of receiving the plan's written decision; Medicare redeterminations within 120 days (rules).11,12 | No client data yet |
| Denial rateReported monthly | Claims denied on the insurance company's first decision, divided by claims decided in the month. Denials that only move the balance to the patient are not counted. | Medical practices saw 7% to 8% of claims denied on first submission across the past four years.7 | No client data yet |
| A/R over 90 daysReported monthly | Open balances on visits more than 90 days past the date of service, divided by net open A/R, at month end. Age does not reset when a claim moves to a secondary payer or the patient. | No neutral public figure found for balances over 90 days. The nearest: median 13.54% of A/R over 120 days (multispecialty practices, 2020 data). Multispecialty medical groups; no free public figure by specialty for most specialties; MGMA's specialty breakouts are subscriber-only.13 | No client data yet |
| First patient statement | Business days from a patient's balance becoming final (insurance has paid its share and nothing is open with a payer) to the first statement going out. | 70% of providers need two or more statements to collect a patient balance in full (2026). In 2024 practices collected 72% of copays at the visit but about 27% of other patient balances.14,7 | No client data yet |
| Days in A/RReported monthly | Open A/R at month end divided by the average daily expected value of visits in the last 90 days. We use expected amounts (what payers allowed) for both open A/R and daily revenue. MGMA's figures value A/R at gross charges, so its adjusted-charges figure reads higher than ours; no public benchmark uses exactly our basis. | Median 35.5 days on gross charges; better performers 26.8 (multispecialty groups, 2020 data). Physician-owned multispecialty groups: 60.31 days on adjusted charges (2020 data). Multispecialty medical groups; no free public figure by specialty for most specialties; MGMA's specialty breakouts are subscriber-only.1,2,15 | No client data yet |
| Month-end report delivered | Business day of the month by which your report arrives. | No client data yet | |
| Data returned when you leave | Business days from the end of the agreement to your data being returned. | HIPAA requires return or destruction at the end but sets no deadline (rule).16 | No client data yet |
Rules that set the clock
These are rules, not benchmarks. They set the deadlines our follow-up works to.
How follow-up works| Rule | What it says |
|---|---|
| Medicare payment window | Medicare cannot pay a clean electronic claim until 13 days after it receives it, and must pay or deny it within 30 days.10 |
| Medicare filing limit | Medicare claims must be filed within one calendar year of the date of service.8 |
| Medicare redetermination | Medicare redetermination requests are due within 120 days of receiving the initial decision.12 |
| Medicare Advantage reconsideration | Medicare Advantage reconsideration requests are due within 60 calendar days of receiving the plan's written decision.11 |
| Medicare Advantage prior authorization | Since 2026, Medicare Advantage plans must decide standard prior authorization requests within 7 calendar days.6 |
| Your data at the end of the agreement | When the agreement ends, a business associate must return or destroy the practice's patient information and keep no copies; if that is not feasible, it must keep protecting it. No deadline is set in the rule.16 |
How we will publish results
Each result will state its definition, the date range, the number of practices, and whether claims inherited from a previous biller are included. Past figures are not edited.
Numbers we will not use
Figures that appear in billing sales material, traced back as far as we could. We do not use them, and we suggest you ask where any billing company's numbers come from.
Questions to ask any billing company| The figure as it circulates | What we found |
|---|---|
| Up to 65% of denied claims are never resubmitted | Traced to a 2018 vendor blog; no study behind it.17,18 |
| 90% of denials are preventable | A 2014 blog post, cited in a 2018 trade article.17 |
| $25 or $117 to rework a denied claim | Vendor blogs; no MGMA source found.18 |
| Average denial rate 11.8% (AHA) | The figure is Kodiak's 2024 number for hospitals and physicians, not the AHA's.19 |
| A vendor's results for its own customers | Not a benchmark. |
Next question: what will the report show me?
What your month-end report contains, and how each number in it is defined.