Medical Billing & Revenue Cycle Metrics: Claims, Denials & Days in AR
Contractual adjustments, clean claim and first-pass rates, a denial Pareto by reason and payer, A/R aging and days in A/R, net collection rate, patient responsibility, cost to collect and an RCM dashboard: 8 graded labs on one fictional practice's synthetic claims.
The first lesson is free — no account needed.
About this course
A medical billing and revenue cycle metrics course for billing staff, practice managers, healthcare administration students and RCM analysts, built on one fictional practice's synthetic claims in a spreadsheet. You split remittance lines into contractual adjustment and patient responsibility, measure the clean claim and first-pass resolution rates, count denials by reason and payer for a Pareto chart, age open claims into buckets and calculate A/R over 90 days and days in A/R, find the net collection rate by payer while keeping controllable write-offs in the denominator, split allowed amounts into copay, deductible and coinsurance, calculate the cost to collect and write-off rates and build a KPI dashboard that knows whether higher or lower is better. Educational only, not billing, coding or legal advice. The first lab is free.
Lessons
- Charges vs Allowed vs Paid: the Contractual AdjustmentFree
- Clean Claim Rate and First-Pass Resolution Rate Pro
- Denial Rate by Reason and Payer with COUNTIF and a Pareto Chart Pro
- A/R Aging, A/R over 90 Days and Days in A/R Pro
- Net Collection Rate by Payer and the Gap to Target Pro
- Patient Responsibility per Claim: Deductible, Copay and Coinsurance Pro
- Cost to Collect and Write-Off Rates by Quarter Pro
- RCM Dashboard: Status, Gaps and Red Flags Pro