Professional services
Medical Practice Collection Rate Calculator
Net collection rate, denial rate and days in receivables, the three numbers that describe a practice's billing health.
Result
Practice administration arithmetic, not clinical or billing advice. Payer contracts, coding rules and the regulations governing patient communication and cancellation policies all vary and change. Nothing here bears on clinical decisions or on how any individual patient should be cared for. Net collection rate measures performance against what you were contractually entitled to collect, which is the meaningful denominator. Gross collection rate, measured against full charges, mostly reflects how charges are set rather than how well billing works. Denials are usually fixable and many are never reworked, which is where the leakage sits.
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About this calculator
Why use net rather than gross collection rate?
Because gross compares collections against charges you were never going to receive. Raising your charge master would lower gross collection rate while changing nothing real.
What drives most of the leakage?
Denials that are never reworked. A large share of first-pass denials are correctable, and practices without a systematic rework process lose them by default.
The formula
net collection rate = collected / (charges - contractual adjustments)
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