Primary Care: 28-35 days
Specialty Care: 32-42 days
Surgery Centers: 25-30 days
Multi-specialty: 35-45 days

Your Target: Top Quartile (20% improvement from current)

Example Calculation:
Total AR: $180,000
Monthly Revenue: $450,000
Daily Revenue: $15,000 ($450K ÷ 30 days)
DSO: $180,000 ÷ $15,000 = 12 days

Wait - that can't be right! 

Common Mistake: Using gross charges instead of net collections
Correct calculation uses NET daily revenue after adjustments

Net Monthly Collections: $380,000 (after adjustments)
Net Daily Collections: $12,667 ($380K ÷ 30 days)  
True DSO: $180,000 ÷ $12,667 = 14.2 days

Still seems low? Check your AR aging!

0-30 Days: $_____ (_____%)  
31-60 Days: $_____ (_____%)
61-90 Days: $_____ (_____%)  
90+ Days: $_____ (_____%)

Healthy Practice Targets:
0-30 Days: 70-80%
31-60 Days: 15-20%  
61-90 Days: 5-8%
90+ Days: <5%

Formula: (Denied Claims ÷ Total Claims Submitted) × 100

Healthy Benchmarks:
Initial Denial Rate: <7%
Final Denial Rate: <3% (after appeals)
Clean Claim Rate: >90%

Priority Actions:
□ Pull all claims showing "processed" but unpaid
□ Call top 20 highest dollar outstanding claims  
□ Collect all patient payments sitting in "pending"
□ Fix obvious claim errors (wrong dates, etc.)
□ Submit held claims immediately

Expected Recovery: $5,000-$25,000 in 48 hours

"Hi, this is [Name] from [Practice]. I'm calling about claim [#] 
for patient [Name] with DOS [Date]. The claim was submitted on 
[Date] and we haven't received payment. Can you provide the 
status and expected payment date?

If unpaid: "What information do you need to process this claim? 
When can we expect payment once provided?"

If denied: "Can you provide the specific denial reason and appeal 
process? I'll need the written denial sent to [fax/email]."

Implementation Steps:
□ Verify benefits and calculate patient portion 48 hours prior
□ Collect estimated patient portion at time of service  
□ Offer payment plans for amounts >$200
□ Set up automatic payment plans for amounts >$500
□ Use payment cards on file for balances >30 days

At Check-in:
"Based on your insurance benefits, your estimated portion 
today is $X. How would you like to take care of that - 
cash, credit card, or would you like to set up a payment plan?"

For Existing Balances:
"I see you have a balance of $X from your visit on [date]. 
We can take care of that today with cash or card, or I can 
set up a convenient payment plan. Which works better for you?"

Day 1: Service provided
Day 7: Claim submitted  
Day 30: First follow-up call
Day 45: Second follow-up + supervisor escalation
Day 60: Third follow-up + appeal process
Day 75: Manager review + collection agency consideration
Day 90: Write-off consideration

High-Success Appeals (65-85% overturn rate):
- Timely filing with documentation
- Eligibility verification errors
- Coding corrections with supporting notes

Low-Success Appeals (<30% overturn rate):  
- Medical necessity without strong documentation
- Experimental/investigational procedures
- Non-covered services per contract

Insurance Follow-up Staff:
- 35-50 follow-up calls per day
- 15-20 claims resolved per day  
- $8,000-$15,000 collected per day

Patient Financial Counselor:
- 25-40 patient contacts per day
- $2,000-$5,000 collected per day
- 8-12 payment plans set up per day

KPI Tracking:
□ DSO trend (weekly calculation)
□ Collections per FTE
□ Clean claim percentage
□ Denial overturn rate
□ Patient collection rate
□ AR aging distribution

DSO Calculation: Updated weekly
Target: 20% reduction from baseline in 90 days

Clean Claim Rate: >90%
First-pass payment rate: >75%
Denial rate: <7%
Appeal success rate: >65%

Average days to payment by payer
Collection rate by service type  
Patient payment rate by amount
AR aging trend analysis
Cost per dollar collected

For Each Major Payer Track:
- Average payment time
- Denial rate  
- Appeal success rate
- Payment accuracy
- Contract compliance

By Provider Track:
- Clean claim rate
- Documentation completeness
- Coding accuracy
- Patient collection rate

High-Impact Automations:
□ Real-time eligibility verification
□ Automated claim submission (daily)  
□ Electronic payment posting
□ Automated patient payment reminders
□ Denial auto-categorization
□ Performance dashboard alerts

EHR to Practice Management:
□ Automatic charge capture
□ Real-time insurance verification  
□ Coding assistance integration
□ Documentation completion alerts

Practice Management to Clearinghouse:
□ Real-time claim scrubbing
□ Automatic rejection correction
□ Electronic remittance processing
□ Status update automation

Leverage Points for Faster Payment:
- High volume with consistent patterns
- Clean claim submission rates >95%  
- Electronic transaction capabilities
- Quality measure performance
- Patient satisfaction scores

Negotiation Targets:
- Reduce payment terms from 30 to 21 days
- Electronic payment requirements
- Interest charges on late payments
- Expedited payment for clean claims
- Direct deposit setup for faster access

Practice Details:
Monthly Revenue: $600,000
Starting DSO: 45 days
Target DSO: 30 days  
Improvement: 15 days

Financial Impact:
Daily Revenue: $20,000 ($600K ÷ 30)
Cash Flow Improvement: $300,000 (15 days × $20K)
Annual Interest Savings: $18,000 (6% on $300K)
Total Annual Benefit: $318,000+

Technology Investment: $5,000-$15,000
Staff Training: $2,000-$5,000  
Process Development: $3,000-$8,000
Ongoing Monitoring: $1,000/month

Total Investment: $15,000-$35,000
Typical Payback Period: 30-60 days