Outsourced physician billing services typically cover claims, denials, AR, and eligibility. See what to outsource fully, partially, or as full-cycle RCM.
The average physician practice denial rate is 9–10%, according to HFMA benchmarks. Best-performing practices maintain a physician practice denial rate below 4%. A denial rate above 10% typically signals systemic issues in eligibility verification, coding documentation, or front-end registration workflows.
Outsourcing medical billing for a physician practice typically costs 4–9% of monthly collections, depending on specialty, volume, and scope of services. Most practices find this less expensive than maintaining a full-time in-house biller when all overhead costs are factored in.
Eligibility verification is the process of confirming a patient's insurance coverage before their appointment. Best practice is to verify 48–72 hours in advance — not at check-in — to catch issues while there is still time to resolve them.
Days in AR (accounts receivable) measures the average number of days it takes a healthcare practice to collect payment after a service is provided. The benchmark is under 40 days.
What is claim denial rate? It's the percentage of claims payers reject on first submission — and if yours exceeds 9.5%, you're likely losing revenue every month.
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