Practical RCM analysis from nearly two decades of hands-on billing operations, by the ABA editorial team.
A claim denial rate above 10% is not bad luck — it's a systemic problem. Here are 7 proven strategies to cut it in half, based on what works in real billing operations across multiple specialties.
When all hidden costs are included, in-house billing typically costs 8–15% of collections. Outsourced billing runs 3–10% — and often delivers better results.
Most claim denials fall into 10 predictable categories. Here's what each one means and exactly how to prevent it before the claim leaves your practice.
Denial rates that don't improve, AR that keeps aging, no transparent reporting — these aren't bumps. They're warnings. Here's what to look for and what to do.
Under 30 days in AR is excellent. Over 50 days is a problem. Here are the current benchmarks by specialty and what to do if yours is too high.
Authorization issues drive up to 30% of DME claim denials. Here's the exact workflow that prevents them — before a single claim gets submitted.
27% of all claim denials trace back to eligibility errors at the front desk. Here's the verification workflow that eliminates them.
Getting managed care contracts is the #1 challenge new and growing practices face. Here's the full process — credentialing vs contracting, fee schedule negotiation, and what to read before you sign.
Credentialing delays mean you cannot bill in-network — and every day costs real money. Realistic timelines by payer, what it actually costs, and when outsourcing pays for itself.
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Checklists, benchmark reports, calculators, and playbooks — built for provider decision-makers, not students.