The 5 Benchmarks
We don't promise vague improvements. We guarantee five measurable outcomes that drive your cash flow.
Every number below is written into your Managed Outcomes Agreement — not marketing copy, a contractual standard your Account Manager is held to.
Hover or tap a card to see how it measures up.
≥ 97%
Clean Claim Rate
Fewer rejections, faster payments, less rework for your team.
≥ 90%
First Pass Resolution Rate
More claims paid on first submission — no edits, no rework.
< 5%
Denial Rate
Top-performer threshold — strong front-end and coding discipline.
< 35 days
Days in AR
Industry benchmark for healthy cash flow — faster conversion of services to cash.
≥ 98¢
Net Revenue Recovery per $1 billed
Maximizes collectible revenue after contractual adjustments and write-offs.
The Risk of "Close Enough"
If your current performance sits below these thresholds, you're leaking revenue and stretching your cash cycle longer than it needs to be.
Reviora vs. Industry Average
Most practices operate inside industry averages. Reviora guarantees top-performer ranges.
Hover or tap a row to see how the guarantee compares.
Source: MGMA DataDive & Cost and Revenue Survey, HFMA MAP Keys — aggregated 2024–2026 industry benchmarking data.
Even a 3–5 point gap in these metrics can mean six to seven figures in annual leakage for multi-provider groups.
How We Calculate & Report
No black boxes. Here's exactly how each metric is calculated and reported.
Submit
Claim sent to payer
Scrub
Errors caught pre-submission
Adjudicate
Payer decision returned
Post
Payment logged to account
Report
Dashboard updated for you
Clean Claim Rate
(Claims paid without edits or rejections on first submission ÷ Total claims submitted) × 100
First Pass Resolution Rate
(Claims paid in full on first submission ÷ Total claims submitted) × 100
Denial Rate
(Denied claims ÷ Total claims submitted) × 100
Days in AR
Total Accounts Receivable ÷ Average Daily Charges (rolling 90-day period)
Net Revenue Recovery
Total payments collected ÷ Total allowed/adjusted charges (expressed as cents per dollar billed)
You receive a client-specific dashboard and PDF report each month, with drill-downs by location, provider, and payer.
What Happens If We Miss the Benchmark
If we miss a benchmark, your Account Manager is accountable — immediately, and in writing.
Every step below is written into your Managed Outcomes Agreement (MOA) — a contractual obligation your Account Manager is measured against, not a courtesy.
IF
A benchmark is missed in a single month
THEN
-
Responsibility sits with your dedicated Account Manager — investigating and resolving the miss is their direct job, not a support ticket routed elsewhere.
-
The root cause and corrective action are documented in writing in your next monthly report — no request required on your end.
Your Account Manager: owns this from the moment the miss is identified. Investigation and resolution begin immediately, and the outcome is tracked back to your MOA.
IF
The same benchmark is missed two consecutive months
THEN
-
The Benchmark Recovery Protocol (BRP) activates automatically — no client request needed to trigger it.
-
A formal, written remediation plan is created with direct oversight from Reviora's Operations Manager.
Your Account Manager: escalates to the Operations Manager, presents the remediation plan in writing, and remains the single point of accountability for driving it through to resolution.
IF
Two consecutive quarters pass with the benchmark still unresolved
THEN
-
The Benchmark Recovery Protocol (BRP) remains active, with continued executive oversight until the benchmark is resolved, as defined in your MOA.
-
Reviora conducts a joint process audit at its own cost, with findings shared directly with your leadership.
Your Account Manager: coordinates with the Operations Manager to present full audit findings and next steps directly to your leadership, in one review.
Every miss, every step, and every resolution is documented in your MOA — your Account Manager is accountable for the numbers, not just the reporting.
What This Doesn't Cover
Client-caused delays — e.g., late documentation or authorization submission
System downtime not caused by Reviora
Payer policy changes or other force majeure events
Even when an exclusion applies, Reviora still works the remediation plan — the timeline resets, but the fix doesn't stop.
Why We Can Guarantee It
Guarantees are only as good as the system behind them. Here's ours.
Drives: Clean Claim Rate, FPRR
Front-End Rigor
Real-time eligibility checks, benefits verification, and prior authorization workflows run before a claim is ever created — not after it bounces back.
Drives: Clean Claim Rate
Specialist-Tuned Claim Scrubbing
Payer-specific and specialty-specific scrubbing rules, built and maintained by credentialed billing specialists, catch preventable errors before submission.
Drives: Denial Rate
Denial Management Playbooks
Standardized appeal workflows for soft denials — medical necessity, prior auth, coding — with documentation built to recover a meaningful share of denied claims, not just refile them.
Drives: Days in AR
AR Segmentation & Cadence
Automated follow-up schedules organized by payer and age bucket keep balances moving and stop small delays from becoming aging creep.
Drives: Net Revenue Recovery
Contract Intelligence
Fee schedule validation and underpayment detection catch payer short-pays and coding drift before they quietly erode your revenue.
Drives: All Five Benchmarks
Quality Assurance & Governance
Monthly QA audits, HIPAA-compliant data handling, and continuous staff training lock in performance and reduce variance across every account.
We only take on clients where we're confident we can hit these targets. If we can't, we'll tell you upfront.
See It In Your Own Numbers
Your current vendor is hoping you don't check the math.
We're inviting you to.
We're inviting you to.
Book a free benchmark review and see exactly where your practice stands against these five numbers — no obligation, no sales pressure.
Book Your Free Benchmark Review
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