If you’ve ever looked at your collections report and felt uneasy without knowing exactly why, you’re not alone. The numbers can look fine while small issues build underneath. By the time those issues show up in collections, they’ve usually been in motion for weeks.
The earliest signs appear in a few specific places.
Charge lag measures the time between a patient encounter and when the claim is submitted to the payer.
For many practices, charge capture still happens in batches. Charts are often closed days after the visit, which delays posting and keeps claims waiting to move forward together. Those small delays can compound quickly, slowing cash flow and creating downstream issues that are harder to unwind later.
MGMA benchmarks show that charge posting across specialty practices can stretch up to 72 hours. That may be considered standard, but it isn’t optimal for a high-volume specialty like dermatology, where cash flow depends on thousands of small, fast-moving claims.
At Clarity, charges are typically submitted within 24 hours once documentation is finalized. That early submission preserves momentum in the revenue cycle, when details are still fresh and issues are easiest to address.
Submitting claims within 24 hours supports steadier deposits and leaves more time to address questions or rejections before filing deadlines become a concern.
Many practices track Net Collection Rate, or what they ultimately collect versus what they are contractually owed. While important, it reflects what’s already happened.
A more predictive metric is the First-Pass Clean Claim Rate, which measures the percentage of claims paid on initial submission without manual intervention.
HFMA’s MAP Keys set the industry benchmark for clean claims at 95%. When first-pass rates fall into the low-80s, practices tend to see slower payments and more staff time diverted to rework.
Clarity-managed practices average approximately 98% on first-pass clean claims. That result reflects strong system configuration and targeted review of higher-risk claims, supported by scrub rules that prevent avoidable denials before submission.
The cost of rework adds up quickly. Industry data estimates that reworking a single denied claim costs about $25. For practices submitting thousands of claims each year, even modest gaps in first-pass performance can quietly consume staff time and operating dollars.
Operational insight: Appeals play an important role, especially as payers increasingly downcode or bundle claims automatically. While clean claims reduce preventable denials, consistent and disciplined appeals are typically required to secure appropriate reimbursement. High-performing revenue cycles combine strong front-end accuracy with the persistence needed to challenge payer behavior that limits appropriate reimbursement.
In reactive environments, work rarely moves in a straight line. Claims require repeated attention, pulling staff away from forward progress and adding touchpoints that could have been handled earlier.
Routine steps such as eligibility checks and statement generation happen automatically. Billing teams spend less time correcting preventable errors and more time focusing on exceptions that genuinely require expertise. As a result, patient communication improves because statements are accurate and predictable.
Here’s an example of what that shift can look like in practice:
A five-provider dermatology group experienced a 12–15 day charge lag because charts were being finalized in batches rather than daily. Until those charts were closed, billing was unable to post charges and submit claims, which contributed to inconsistent cash flow and a growing 90+ day AR bucket.
After moving to daily charge capture, setting a 24-hour chart completion expectation, and introducing automated eligibility and modifier checks, charge lag dropped below 24 hours, first-pass clean claim rates increased from 84% to 96%, and the 90+ AR balance was reduced by nearly half.
Total Accounts Receivable tells only part of the story. AR aging provides an early signal into how effectively the revenue cycle is functioning.
Dermatology practices manage a mix of high-volume, lower-dollar claims alongside higher-value procedures. Without consistent follow-up, smaller balances and denied claims can quietly age into financial risk, even when overall collections appear stable.
Industry benchmarks place Days in AR for independent practices between 30 and 40 days. Clarity-managed practices average 23 days, reflecting faster resolution and tighter operational control across the full claim lifecycle.
A similar pattern shows up in older balances. Industry guidance recommends keeping AR over 90 days below 15%. Clarity maintains this bucket at approximately 7%, signaling disciplined denial prevention and follow-through before claims drift into risk.
When AR aging begins to move in the wrong direction, it’s rarely the root problem. In most cases, the underlying cause lives earlier in the revenue cycle, where delays and rework first take hold.
Revenue cycle performance is shaped upstream long before collections are posted. Charge lag, claim quality, billing workflows, and AR aging each offer early signals about how reliably cash is moving through the practice.
Looking at these signals together provides a clearer view of financial performance and where friction is beginning to build. When they are aligned, the revenue cycle becomes easier to manage and more predictable over time.
