Key RCM Metrics Primary Care Practices Should Monitor

Revenue Cycle Management (RCM) is more than just billing and collections—it’s a strategic process that determines the financial health of your Primary Care practice. With increasing payer complexities, tighter margins, and evolving value-based care models, monitoring the right metrics is crucial to staying profitable and efficient.

At MediClarus, we’ve seen that Primary Care practices that consistently track these metrics reduce denials, improve cash flow, and strengthen their long-term sustainability.

1. Days in Accounts Receivable (A/R)

What it means: The average number of days it takes for your practice to receive payment after a claim is submitted.Why it matters: High A/R days indicate inefficiencies in claim processing, payer follow-up, or patient collections.Benchmark: Aim for <30 days in A/R to maintain healthy cash flow.

2. First Pass Claim Acceptance Rate (FPAR)

What it means: The percentage of claims accepted and paid by payers on the first submission.Why it matters: A low FPAR signals coding errors, incomplete documentation, or payer-specific issues.Benchmark: Target >95% acceptance to minimize rework and delays.

3. Denial Rate

What it means: The percentage of claims denied by payers.Why it matters: Frequent denials drain staff time and revenue, often caused by eligibility errors, lack of authorizations, or incorrect coding.Benchmark: Keep denial rates under 5% for optimal performance.

4. Cost to Collect

What it means: The total cost your practice spends to collect revenue, including staff time, technology, and administrative costs.Why it matters: High costs reduce profitability, especially in Primary Care where margins are already thin.Benchmark: Strive for less than 3% of net patient revenue.

5. Net Collection Rate (NCR)

What it means: The percentage of collectible revenue your practice actually receives.Why it matters: A low NCR often points to write-offs, poor follow-up, or inefficiencies in collections.Benchmark: >95% NCR indicates a well-managed revenue cycle.

6. Clean Claim Rate (CCR)

What it means: The percentage of claims submitted without errors.Why it matters: High CCR means fewer delays, faster payments, and less manual intervention.Benchmark: Aim for >97% clean claims.

7. Patient Collections Ratio

What it means: The percentage of patient balances collected after insurance payments.Why it matters: With rising deductibles, this metric directly impacts revenue and cash flow.Benchmark: Target 90%+ patient collections with transparent billing and flexible payment options.

Why These Metrics Matter for Primary Care

Unlike specialties that focus on fewer, high-value claims, Primary Care practices depend on volume. Even minor inefficiencies—like slow A/R days or a 2–3% higher denial rate—can lead to significant revenue loss over time.

Tracking these metrics gives practices:

✔️ Better visibility into cash flow

✔️ The ability to identify and fix bottlenecks

✔️ Insights to plan staffing and workflows effectively

How MediClarus Helps Primary Care Practices

At MediClarus, we specialize in optimizing RCM for Primary Care practices. Our team uses data-driven reporting to:

• Reduce claim denials

• Speed up reimbursements

• Improve collections

• Lower operational costs

By combining expertise with automation tools, we ensure every metric is monitored, analyzed, and improved—so your practice focuses on what matters most: patient care.

📩 Contact MediClarus today to see how we can help you strengthen your revenue cycle performance.