Category: RCM Fundamentals

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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