1. Verification of benefits and collection of copayments: 100 percent
2. Preauthorizations: 100 percent
3. Coding review and claim scrubbing: 100 percent
4. Clean claim submission rate: 95 percent or more, optimally near 98 or 99 percent
5. Denial rate: less than 5 percent
6. Accounts receivable: 95 percent paid within 60 days
7. Adjusted collection rate: between 98 and 99 percent
8. Accounts receivable over 120 days: less than 3 percent
9. Reimbursement ratio: closed claims and overall claims should be one-to-one
10. Negotiating fee schedule: 100 percent optimal
For more explanation on any benchmark, download the report here.
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