Denials, claims delays and outsourcing: 6 survey findings on RCM metrics

A new American Medical Group Association survey provides insights into revenue cycle management metrics at U.S. medical practices, including denials, claims lag times and staffing.

The survey, conducted by AMGA Consulting, includes data from nonprofit and for-profit medical groups nationwide, representing more than 15,300 provider full-time equivalents. More than half of responses (54 percent) came from integrated systems and 46 percent came from independent practices.

Six survey findings about revenue cycle metrics:

1. Seventy-three percent of respondents reported that their practice completes insurance verification before outpatient visits at least 90 percent of the time.

2. The average time from the date of service until claims are submitted to the payer was 7.6 days among respondents.

3. The average time from the date of service to coding review was 6.7 days among respondents.

4. Upon first submission, the average amount of claims rejected or denied was 5.5 percent among respondents.

5. Half of respondents said their practice's denial rate was 5 percent or below, but 15 percent reported a denial rate of more than 10 percent.

6. Of the 1,533 clinics that reported revenue cycle staffing details, 43 percent said they outsource some revenue cycle component.

Read more about the survey here and here.


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