Free RCM Calculator: How Much Is Your Current Billing Costing You?

You may be missing out on thousands of dollars each month due to your current RCM (revenue cycle management) process. This is money you’re rightfully owed for services you’ve already delivered… but that the insurance payers are holding back from you.

>> Jump to the Calculator to Find Out How Much Revenue You’re Missing

The good news is you can start claiming more of this revenue right away. We know this because we’ve seen it firsthand with multiple healthcare providers. Here’s why upgrading your billing can have such a big impact on your practice…

• By collecting more from insurance, you’re paid fairly for services you’re already providing.
• You don’t need to hire additional staff or increase admin costs. In fact, by making the billing process more efficient, you’ll reduce the overall admin burden.
• This doesn’t require paying anything up-front. Billing providers are paid via a small percentage on the money they collect. In other words, they win when you win.
• You get paid faster and don’t have to wait as long for claims to process.
• You can get results quickly. Usually, you’ll see an influx of cash within 30-60 days.

The real question is…

What would you do with an extra $5k, $10k, $30k, or even more in monthly revenue for your practice? Maybe you’d focus on growth and expanding your services. Maybe you’d put the funds toward creating even better outcomes for your patients. Or maybe you’d save up extra cash for a rainy day.

Either way, this extra revenue is available to you in the next few months. So let’s see what this looks like for your practice specifically…

How Our RCM Calculator Works

We take industry standard results for insurance billing and compare it to what’s possible with a fast, efficient billing process. This includes:

• Monthly Revenue: How much do you typically generate each month.
• Average Claim Value: This is the average size of each claim you submit. We use an industry standard estimate of $150/claim for our calculation.
• Collections Rate: Increasing this means increasing the total revenue you successfully collect from insurance. The standard is around 88%, but an efficient process will get closer to 97%.
• Claim Denial Rate: Besides impacting your overall collections, denials add significant admin time/cost due to resubmitting claims. Many practices see a rate of around 19%. But it’s possible to get this down to 7.5% or lower.
• Current Days in A/R: This is the average time it takes to get paid on claims. Dropping this from the industry standard of 52 days down to 25 days can create an immediate windfall of cash for your practice (as you move all your payments forward by a month).

If you have specific numbers for your organization, you can use them in the calculator to create a more accurate estimate. But we also include the industry benchmarks since not every practice knows their billing metrics off-hand.

The calculator works by comparing your current billing performance to what’s achievable with industry best practices.

Monthly Revenue Gain comes from two improvements: First, we look at how much more you could collect by improving your collections rate to 97%. Second, we calculate the savings from reducing your denial rate to 7.5%. Besides improving your collections, this saves you about $25/claim in administrative cost to rework each denial.

Collections Gain = MonthlyRevenue * (97% - CollectionRate) / 100

Monthly Claims = RevenueMonthly / AvgClaimValue

Admin Savings = $25 * MonthlyClaims * (DenialRate - 7.5%) / 100

Monthly Gain = Collections Gain + Admin Savings

One-Time Cash Boost represents immediate cash flow from clearing your claims backlog. When you reduce your days in A/R to the 25 day best practice standard, you essentially move all your outstanding receivables forward by that many days.

Daily Revenue = MonthlyRevenue / 30 days

Cash Boost = DailyRevenue * (CurrentDaysAR - 25 days)

Total First Year Impact combines everything:

Total Impact = (Monthly Gain * 12 months) + Cash Boost

This is designed to give you a rough sense of what’s possible for your practice. Individual results will vary based on your specific specialty, payer mix, and current billing processes. For precise projections tailored to your practice, schedule a free billing audit where we’ll analyze your specific billing data and provide precise revenue improvement estimates.

Free RCM Revenue Calculator

How much you can make by upgrading your medical billing today?

Enter your practice information in the form below. If there’s something you don’t know, put “Not Sure” to use an estimate based on industry benchmarks. (This produces a conservative estimate since many practices see worse billing results than the national average.)

Note: We respect your private information. This tool works locally in your web browser, and any information filled out below will not be shared with us unless you explicitly do so.