Medical Billing Best Practices

If you are not following the best practice standards (or if your current technology vendor/service cannot show you this data), it is time to reconsider changes to your medical billing software and processes.

Best Practice Your Current
Claim Scrubbing 100%
Average Days A/R < 40 Days
Claims Paid in < 45 days 85-90%
Denial Rate < 3-5%
EOBs Review 100%
Average Days in A/R over 120 < 12-15%
Total Unpaid Claims < 4%
Net Collection Rate > 96%
Days from TOS to Billing < 3 days
Eligibility Verification 100%

Medical Billing Best Practices

Best Practice Your Current
Claim Scrubbing 100%
Average Days A/R < 40 Days
Claims Paid in < 45 days 85-90%
Denial Rate < 3-5%
EOBs Review 100%
Average Days in A/R over 120 < 12-15%
Total Unpaid Claims < 4%
Net Collection Rate > 96%
Days from TOS to Billing < 3 days
Eligibility Verification 100%