Revenue cycle KPIs tell you how fast you’re turning work into cash and where you’re leaking. If you only look at “are we getting paid,” you’re too late. These numbers give you a lead indicator.
KPIs that move the needle
Days from SOC to RAP submission: the sooner you submit the RAP, the sooner you get the initial payment. Days from discharge (or end of episode) to final claim submission: delays here push revenue into the next month or quarter. Denial rate: percent of claims denied on first submission. For root causes and appeals, see denial management and appeals. Clean claim rate: percent of claims paid without takebacks or adjustments. Aging: how much revenue is in 30, 60, 90+ days. Track these by payor if you can,one bad contract can skew the average.
Targets
There’s no single right number; it depends on your payor mix and systems. But in general: RAP within 5–7 days of SOC is achievable for many agencies. Final claim within 10–15 days of episode end. Denial rate under 5–10% (lower is better). Aging over 90 days should be a small fraction of total. If you’re above those, set a target to improve by a percent or a few days each quarter.
Who owns it
Someone has to own the numbers. That might be billing, operations, or the CFO. They need access to the data,from your billing system or EHR,and a regular review (weekly or monthly). When a KPI slips, the owner tracks down why and fixes it. We have a revenue cycle KPI worksheet you can download: the main metrics, how to calculate them, and a simple log for targets and actuals.