RCM KPI Guide
The KPIs Claim Harbor calculates — and how it reads them.
This guide mirrors the in-product KPI Library exactly: the same formulas, the same plain-language explanations, and the same directional review ranges the application uses.
Methodology reviewed: September 1, 2026
Methodology
How to read the ranges.
Claim Harbor benchmark ranges are directional review guidance. They are not payer-specific, specialty-specific, or guaranteed financial findings.
Each calculated KPI is compared to its range and labeled Strong, Watch, or Needs review. Values close to a range read as Watch rather than Needs review, so small period-to-period movement does not overstate a problem. The labels are review prompts — they are not audit findings, and they do not account for payer mix, specialty, contract terms, or local market conditions.
Reference
KPI definitions, formulas, and ranges.
Net Collection Rate (NCR)
Directional range 96–98%Share of the collectible amount you actually collected after contractual write-offs.
The clearest recurring signal of how effectively the organization is collecting what it is contractually owed. Reviewed period over period, it shows whether follow-up work is keeping pace.
Gross Collection Rate (GCR)
Directional range 55–70%Payments as a share of full billed charges, before contractual adjustments.
Context for fee schedule and payer mix rather than a quality signal on its own. Useful in a recurring review to explain movement in other measures.
Days in A/R (Days A/R)
Directional range 15–30 daysAverage days it takes to collect on billed charges.
A directional read on cash velocity. In a recurring review it shows whether claims are moving faster or slower than the prior period.
A/R over 90 Days (A/R > 90)
Directional range 5–10%Portion of A/R that is more than 90 days old.
The 90-day bucket is where receivables are most likely to become uncollectible, which makes it a natural recurring follow-up priority.
Denial Rate (Denial Rate)
Directional range 2–5%Share of submitted claims denied by payers.
Denials create rework and slow cash. Tracked each period, the rate shows whether front-end changes are holding.
Clean Claim Rate (Clean Claim Rate)
Directional range 95–98%Share of claims accepted on first submission without edits.
First-pass clean claim rate is the earliest indicator of billing quality, so it belongs in every recurring review.
Further reading
Educational references.
Industry organizations publish general revenue-cycle education. These links are provided for further reading only; Claim Harbor's own formulas and ranges above remain the product source of truth, and no endorsement or certification is implied.