RCM Benchmarks for Independent Practices

BillingBench publishes independent revenue cycle management benchmarks for independent physician practices. All data is sourced from MGMA Physician Practice benchmark reports, HFMA publications, CMS administrative data, and peer-reviewed literature. BillingBench has no affiliate relationships with any software vendor, payer, or clearinghouse. There is no sponsored content and no advertising.

The benchmark library covers six core revenue cycle metrics: initial denial rate (industry average 5–10% across specialties, per MGMA 2024), first-pass clean claim rate (target 95% or higher), days in accounts receivable (target below 35 days for most specialties), net collection rate (target 95–97%), appeal overturn rate (40–60% for soft denials), and cost to collect (target below 3% of net revenue). Each figure is cited to its primary source with publication date and methodology notes.

Free tools available without an account include the Denial Risk Tool (scores six revenue cycle metrics against MGMA benchmarks), the Denial Code Lookup (CARC and RARC definitions with appeal strategies), the Denial Decoder (step-by-step decision trees for 47 denial codes), the Appeal Letter Builder (generates regulatory-cited appeal letters from denial code and clinical detail), the Prompt Pay Interest Calculator (computes interest under applicable state statutes), and the Prompt Pay Statute Reference (all 50 states plus DC).

Workspace accounts add denial queue management, saved appeal letters with outcome tracking, 835 ERA remittance file parsing with HIPAA-aware browser-only processing, appeal success benchmarking against specialty peers, and community payer alerts. A Business Associate Agreement is executed at signup — no separate compliance step. TOTP two-factor authentication is required for all workspace users.

• RCM benchmarks — denial rates, days in AR, clean claim rates
• Benchmarks by medical specialty
• Denial Risk Tool — free RCM scoring against MGMA benchmarks
• Appeal Letter Builder — regulatory-cited denial appeals
• Denial Decoder — step-by-step appeal decision trees
• Denial code lookup — CARC and RARC reference
• State prompt pay statutes — all 50 states
• Payer intelligence — denial patterns and prior auth requirements
• Medical billing software evaluations
• Pricing — workspace plans for practices and billing teams