EPISODE SUMMARY
Are you running a practice, or are you just moving pieces around a board while your bank account stays empty? In this episode, Jeremy Zug dives into the high-tangible world of Revenue Cycle Management (RCM) to discuss the vital signs of your practice’s financial health.
As a clinician, you might be used to the "wait and see" approach in a therapy session, but in the billing world, "wait and see" is a slow-motion train wreck. Jeremy breaks down the four essential Key Performance Indicators (KPIs) that act as diagnostic tools for your business. From the "perishable good" that is your insurance aging report to the uncomfortable but necessary conversations around patient balances, this episode is a masterclass in shifting from a "starving artist" trope to a "money mind" that wins.
KEYWORDS
Private Practice, Revenue Cycle Management, Insurance Billing, KPIs, Mental Health Billing, Cash Flow, Practice Growth
TAKEAWAYS
The 90-Day Rule: Money is a perishable good. In 2026, a healthy practice should have less than 15% of its total accounts receivable in the 90+ day bucket. After 90 days, the probability of collection doesn't just dip—it collapses.
Process vs. Billing Problems: If your patient aging is spiking, it’s usually a front-end process issue. Are you verifying eligibility before the first session? Waiting 90 days to tell a client they owe $500 is unprofessional and erodes the clinical trust you've built.
The 5% Denial Benchmark: While the industry average for mental health is near 15%, you should aim for a denial rate at or under 5%. If you’re at 20%, you aren’t billing insurance—you’re a pen pal with a computer programmed to ignore you.
Speed is Leverage: Resolution on denials (appealed, resolved, or closed) should happen within 72 hours. Insurance bureaucracy is built on the hope that you’ll get tired and go away; speed is your only real leverage.
The Clean Report Mirage: Don't let a "perfect" aging report fool you. Verify your net collection rate against what is actually arriving in your bank account to ensure the data isn't being manufactured to look clean.
CHAPTERS
00:00 Introduction: The Hidden Tension Between Care and Cash Flow
03:11 KPI #1: Measuring What You’re Owed (Before It Disappears)
05:39 KPI #2: Managing Patient Receivables Effectively
06:57 KPI #3: Denial Rate and Claim Performance
09:10 KPI #4: How Fast You Resolve Denials
10:15 Case Studies: Two Practices, One Hidden Problem
12:59 Practice Owners: Focus on Care, Not Claims
14:18 Conclusion: Building a Measurable, Sustainable Practice
RESOURCES
Today Sponsors: Jane | One Month Grace Period Promo Code: PRACTICESOLUTIONS1MO
Learn More About The Claim Game: Visitpracticesol.com/podcast
The Hourglass Learning Hub: Dive deeper into RCM best practices and downloadable tools mentioned in this episode, like the various checklists and templates, by visitingThe Hourglass Learning Hub.
Our Blog: Explore years of educational articles on billing and practice management atPractice Solutions Blog.
Book: For a comprehensive guide on navigating insurance, grab your copy of Insurance Billing Basics: Steps for Therapists to Successfully Take Insurance.
Images: Aging Follow-up KPI Dashboard
