A medical practice can show positive revenue and still feel short of cash. Charges may be posted late, claims may be denied, or payments may sit unresolved in accounts receivable. A single A/R total does not show where the delay began.

In brief: Review days in A/R, aging by payer, denial rate, clean claim rate, and charge lag together to locate revenue cycle delays.

MGMA’s June 2026 poll found that 84% of responding medical groups had higher year to date operating costs than the prior year. Its reporting also points practice leaders to aging A/R, payer delays, denials, and patient balances as places where cash conversion can slow. Survey results are not a benchmark for every specialty or practice size. Operating cost report | Financials and Operations report

Key Takeaways

  • Track days in A/R, aging by payer, denial rate, clean claim rate, and charge lag.
  • Segment by payer, location, and service line when the data is reliable.
  • Separate new denials from older unresolved balances.
  • Assign a person and next action to every material variance.

The five measures

1. Days in accounts receivable. This estimates how long collection takes after services are provided. Use one consistent formula. A rising number can reflect slower claims, posting delays, payer changes, or a different service mix. It does not identify the cause alone.

2. A/R aging by payer and age. Use consistent bands such as current to 30 days, 31 to 60, 61 to 90, and over 90 days. Separate by payer and patient responsibility where possible. Confirm how unapplied cash, credits, and pending claims are treated before comparing reports.

3. Denial rate and reasons. Measure denials as a share of claims or dollars and hold the definition steady. Group reasons by payer and service. Eligibility, authorization, coding, documentation, and timely filing require different fixes. Review new denial patterns regularly so the same error does not repeat.

4. Clean claim rate. Define whether the measure uses claims, encounters, or dollars and whether it includes pre adjudication rejections. It is one indicator of front end quality. It cannot replace monitoring adjudication and payment.

5. Charge lag. Track the time between a service and submission of its charge. Break it down by department where possible. Observe the workflow to see whether the delay starts with documentation, coding, charge capture, or a system handoff before deciding to add staff or software.

Turn the dashboard into action

The monthly dashboard shows movement. A weekly action list resolves it. For each metric outside the practice’s expected range, record the amount and age, affected payer or service, confirmed or suspected reason, next action, owner, and review date. Sample accounts to verify the summary. Confirm actions follow payer contracts, privacy rules, and billing policies.

Common Questions

What revenue cycle metrics should a medical practice track?

Start with days in A/R, A/R aging by payer, denial rate and reason, clean claim rate, and charge lag. Use consistent definitions and add measures appropriate to the specialty.

What does an increase in days in A/R mean?

Receivables are taking longer to collect under the practice’s calculation. Review aging, payer mix, denials, posting, and charge lag to locate the cause.

Related reading: Where Your Cash Actually Disappears and Why Profitable Businesses Still Run Out of Cash.

This article provides general business information, not medical, coding, billing, legal, or reimbursement advice. Review decisions with qualified revenue cycle and compliance professionals.