RCM Assessment

Revenue Cycle Management Health Check

Review eight common revenue-cycle workflows and generate a simple consistency score based on your responses.

Review eight core RCM workflows

Answer eight questions about common billing and revenue-cycle processes. Each response receives 0–2 points and the total is converted to a percentage.

What this score means

The score reflects only the consistency of the workflow responses you select. It is not an industry benchmark, financial audit or guarantee of revenue performance.

Use the result to prioritize

Focus first on the workflow areas marked inconsistent or incomplete, then review the underlying operational causes.

1. Eligibility verificationHow consistently is insurance eligibility verified before or at the time of service?
2. Prior authorization trackingHow consistently are authorization requirements, approval numbers and expiration dates tracked?
3. Claim submission timelinessHow consistently are completed encounters converted into claims without avoidable delay?
4. Claim quality reviewHow consistently are claims checked for missing data, coding issues and payer edits before submission?
5. Denial root-cause trackingHow consistently are denials categorized and reviewed for recurring causes?
6. A/R follow-upHow consistently are unpaid and underpaid claims worked according to an aging/follow-up schedule?
7. Payment reconciliationHow consistently are payments and adjustments posted and reconciled against expected reimbursement?
8. RCM reportingHow consistently are key billing metrics reviewed by the practice or billing team?

Need help reviewing your billing workflow?

Use your calculation as a starting point, then request a complimentary billing review to discuss denials, A/R, billing cost and workflow improvement opportunities.