If your revenue cycle isn’t measured, it can’t be improved.

For mid-sized specialty practices, a few key RCM (Revenue Cycle Management) metrics can reveal a lot about financial health, operational efficiency, and how well your team is actually getting paid for the care you deliver. But here’s the catch: most practices either track too many numbers—or the wrong ones. To help you focus, here are five high-impact RCM metrics your team should review every week, plus actionable ways to improve them using automation and AI-driven tools.

1. Days in Accounts Receivable (AR)

What it tells you: How long it takes, on average, to collect payments after a service is rendered.

Why it matters: The longer claims sit in AR, the more likely they are to be denied or written off. A healthy AR is typically under 40 days for specialty practices.

How to improve it:

• Use automated follow-ups on aging claims
• Flag high-dollar or stale claims for priority action
• Improve front-end eligibility verification to prevent denials
  

2. First Pass Resolution Rate (FPRR)

What it tells you: The percentage of claims paid on first submission—without rework.

Why it matters: A low FPRR leads to delays, more staff hours, and higher denial rates. Industry benchmarks vary, but many aim for >90%.

How to improve it:

• Automate claim scrubbing before submission
• Use AI-driven coding assistants to improve documentation accuracy
• Monitor payer-specific rules and updates weekly
  

3. Clean Claims Rate

What it tells you: The percentage of claims submitted without errors or omissions.

Why it matters: High error rates in claims lead directly to delays in reimbursement and increased denials.

How to improve it:

• Integrate real-time claim validation tools
• Establish front-office SOPs for capturing patient data accurately
• Use AI-powered eligibility checks before the visit

4. Denial Rate

What it tells you: The percentage of claims denied by payers.

Why it matters: Denials are often preventable and costly. The average denial rate across the industry is around 5–10%, but many practices unknowingly accept higher rates.

How to improve it:

• Track top denial reasons weekly by payer
• Use automated denial management workflows
• Conduct regular training for clinical and billing teams

5. Net Collection Rate

What it tells you: The percentage of collectible revenue that your practice actually collects.

Why it matters: This is the gold-standard metric for revenue cycle performance. Anything under 95% should raise questions.

How to improve it:

• Identify underpayments with AI reconciliation tools
• Monitor write-offs and adjustments closely
• Work aged claims with a focused, segmented approach
  

Final Thoughts

Tracking these metrics weekly may sound like a big lift—but with the right tools, it becomes automatic. At Athelas, we build solutions that help specialty practices automate revenue workflows, reduce denials, and improve cash flow without hiring more staff. With the right visibility and support, you can spend less time chasing dollars and more time delivering excellent care.

See how automation can transform your revenue cycle. Book a demo today with our RCM team.