Are You Leaving Money on the Table — And Do You Even Know It?
Most medical practices don’t believe they’re leaving money on the table. Claims are going out. Payments are coming in. The lights are on. From the outside, everything appears to be working.
But here’s the uncomfortable truth: revenue leakage rarely shows up as a crisis. It hides in small inefficiencies, underpayments, missed follow-ups and “that’s just how it’s always been done” processes. Over time, those small gaps add up to real dollars — often without anyone realizing it.
The bigger issue isn’t whether money is being left on the table. It’s whether you have a clear way to know.
Benchmarking your billing performance doesn’t mean tearing everything down or changing vendors tomorrow. In many cases, minor tweaks and better visibility can lead to meaningful improvements — without rocking the boat.
To get started, ask yourself these seven questions.
1. Do You Know How Your Collections Compare — Or Just What They Are?
Knowing your monthly collections is not the same as knowing whether they’re good.
How does your net collection rate compare to similar practices in your specialty? Are you consistently collecting what you’re contractually owed, or just accepting what comes in?
Without benchmarking against peers, underperformance can feel normal — especially if revenue is steady. Outside billing experts often bring this context, helping practices see where they fall within industry norms and where opportunity exists.
2. Are Underpayments Being Identified — Or Quietly Accepted?
Many underpaid claims don’t look “wrong” at first glance. They post cleanly. They don’t deny. They simply pay less than expected.
Do you have a reliable way to flag underpayments and determine whether they’re worth appealing? Or are they slipping through because staff time is limited?
Even recovering a small percentage of underpaid claims can lead to noticeable gains, especially when processes are streamlined rather than manual.
3. How Quickly Are Claims Being Worked After Payment or Denial?
Timing matters. The longer a claim sits, the less likely it is to be resolved favorably.
Are denials and partial payments reviewed promptly, or do they pile up until there’s time to get to them? Are deadlines ever missed because follow-up happens too late?
Often, improving turnaround time doesn’t require more staff — just clearer workflows and prioritization. This is an area where a fresh set of eyes can spot bottlenecks that internal teams may no longer notice.
4. Are Your Front-End Processes Supporting Clean Claims?
Billing success starts long before a claim is submitted.
Are eligibility checks consistent? Are authorizations tracked and documented properly? Are patient demographics and insurance details routinely verified?
Small front-end gaps create downstream rework that costs time and money. Addressing them usually doesn’t disrupt operations — but it can dramatically improve first-pass claim acceptance.
5. Do You Know Which Payers Create the Most Work for the Least Return?
Not all revenue is equal.
Do you know which payers generate the most denials, delays or appeals? Are certain contracts consistently underperforming compared to others?
Benchmarking payer performance helps practices focus effort where it actually pays off — rather than spreading staff time evenly across accounts with very different outcomes.
6. When Was the Last Time Your Billing Processes Were Evaluated?
Many practices rely on processes that worked years ago — before payer rules tightened, reimbursement models shifted and administrative burden increased.
When was the last time someone objectively reviewed your billing workflows, KPIs and follow-up strategies? Not to overhaul them — but to refine them?
Outside billing experts can provide this kind of assessment without disrupting daily operations, offering targeted recommendations that align with how your practice already functions.
7. How Old Is Your Money — And How Much of It Is Still Collectible?
Not all accounts receivable are created equal.
Do you know how much of your AR is sitting at 30 days, 60 days or 90+ days? Or does it all get lumped together as “outstanding”?
As a general benchmark, the majority of receivables should be collected within 60 days. Once balances age beyond that, the likelihood of full recovery drops — and the amount of effort required to collect increases.
If a significant portion of your AR lives in the 90-day range, it may signal delayed follow-up, payer-specific issues or process gaps that quietly slow cash flow. This doesn’t necessarily mean your billing is broken — but it does mean there’s room to tighten timelines and improve efficiency.
An outside billing review can help practices evaluate AR aging trends, identify why money is stalling and implement adjustments that speed up collections without disrupting existing workflows.
Small Changes, Real Impact
Benchmarking isn’t about finding fault. It’s about clarity.
When you understand how your billing performance compares — and where small adjustments can make a difference — you gain control. In many cases, practices discover they don’t need sweeping changes to improve efficiency and revenue. They just need better insight and a few strategic refinements.
This is where outside billing expertise can be especially valuable. An objective review can help answer these seven questions, highlight opportunities you may not see internally and prioritize adjustments that make sense for your practice without disrupting what’s already working.
If you’ve never asked these questions, now is the time. Because the money you don’t realize you’re leaving on the table is often the easiest to recover.