Short answer: Track five numbers monthly: days in AR (aim under 40), clean claim rate (95% or higher), net collection rate (95% or higher), denial rate (under 5%) and the share of AR older than 90 days (under 15%). Together they show whether you are being paid fully and on time.
Benchmarks at a glance
| KPI | Healthy benchmark | Warning sign |
|---|---|---|
| Days in AR | Under 40 days | Over 50 days |
| Clean claim rate | 95% or higher | Under 90% |
| Net collection rate | 95% or higher | Under 90% |
| Denial rate | Under 5% | Over 10% |
| AR over 90 days | Under 15% of total AR | Over 25% |
These are commonly cited industry benchmarks; specialty and payer mix shift them. Compare yourself against your own trend first.
How to calculate each
- Days in AR = total accounts receivable divided by average daily charges (charges for the last 90 days divided by 90).
- Clean claim rate = claims accepted on first submission divided by total claims submitted.
- Net collection rate = payments divided by (charges minus contractual adjustments), for the same period.
- Denial rate = claims denied divided by claims submitted.
- AR over 90 days = AR older than 90 days divided by total AR.
What to do when a number slips
Rising days in AR usually means follow up is falling behind. A falling clean claim rate points to front end problems: eligibility, coding or missing fields. A weak net collection rate with a normal denial rate often means underpayments are going unchallenged. Read the denial codes guide for the most common fixes.
