Sample Monthly RCM Report
The monthly summary every client receives: collections, A/R, denials and next actions. Fictional practice, illustrative numbers.
Fictional practice. All figures are illustrative.
SAMPLE / DEMONSTRATION DATA. This report describes a fictional practice. It is not a real client.
1. Summary
September collections were $142,300, up 3.7% from August. Days in A/R fell from 38 to 35. The main open issue is eligibility denials from one Medicare Advantage plan after its January network change.
2. Key measures
| Measure | This month | Last month | Target |
|---|---|---|---|
| Collections | $142,300 | $137,200 | Trending up |
| Days in A/R | 35 | 38 | Under 40 |
| Clean claim rate | 95.4% | 94.8% | 95%+ |
| Denial rate | 5.1% | 5.9% | Under 5 to 10% |
| Charge lag | 1.3 days | 1.6 days | Under 2 days |
3. Top denial reasons
| Reason (CARC) | Claims | Dollars | Action |
|---|---|---|---|
| CO-27 coverage terminated | 18 | $3,420 | Eligibility check before each visit |
| CO-197 no authorization | 9 | $4,980 | Auth tracker reviewed weekly |
| CO-16 missing information | 11 | $1,760 | Referring NPI added to charge template |
4. Next month
- Appeal 9 authorization denials before the 60-day deadline.
- Recheck coverage for patients of the affected Medicare Advantage plan.
- Review underpayments on 99214 from one commercial payer.
Benchmarks are common industry targets, not guarantees. Results vary by practice, specialty, payer mix, claim volume, billing history and documentation.
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