A 10-minute monthly billing check every practice owner should do
You do not need to audit your billing every month. You need five numbers, and ten minutes, to know whether it is healthy or quietly drifting.
1. Collections against charges
Compare what you billed to what you actually collected. One month on its own means little, so look at the trend across three to six months. A steady gap that widens is the signal, not any single month.
2. Days in A/R
How long, on average, money sits unpaid after you bill it. Watch the direction more than the absolute number, because it varies by specialty and payer mix. Rising days in A/R almost always means claims are sitting in a status nobody is working.
3. A/R by age bucket
Split outstanding money into 0 to 30, 31 to 60, 61 to 90 and over 90 days. The over-90 bucket is the one that matters. Money that old is harder to collect and often close to a filing or appeal deadline. If that bucket is growing month over month, something upstream is broken.
4. Denial rate and the top denial reasons
Two parts, and the second is the useful one. Knowing you have denials is not actionable. Knowing that most of them are eligibility and prior authorisation tells you exactly which step to fix. The same handful of reasons usually repeat, which is good news: fixing the cause is worth far more than winning appeals one at a time.
5. Payments by payer
Which insurers actually pay you, how much, and how fast. This is the number most practices never look at, and it is the one that informs contract negotiations. If a payer is slow, underpaying, or denying at a higher rate than the rest, you want that documented before your next contract review.
Make it a habit
Put the same ten minutes in the calendar on the same day each month. Ask your biller or billing company for a one-page report with those five numbers on it. If you cannot read your billing report in five minutes, the report is the problem, not your attention span.
What you are looking for is not a perfect month. It is a direction. Three months of drift in the same direction is worth a conversation; one bad month usually is not.