Revenue cycle management (RCM)
Revenue cycle management is the entire financial process of a patient encounter, from scheduling and insurance verification through coding, claim submission, and final payment collection. RCM covers every step where a dollar can enter, stall, or disappear from your revenue stream.
Why this matters for your clinic
Stan's own estimate: clinics that accept private insurance often collect 12-18% less than their contracts actually entitle them to, lost somewhere in this cycle. Most owners only see the beginning (appointments) and the end (bank deposits), not the many steps in between. Every step is a potential leak point.
A broken revenue cycle does not announce itself. It shows up as slow collections, rising AR days, and margins that shrink even when patient volume grows. The fix is not working harder. It is mapping every step and finding where claims get stuck, denied, or written off prematurely.
Clinics that actively manage their revenue cycle collect more per visit, collect faster, and spend less on rework. It is not glamorous work, but it is where most of the recoverable money hides.
What good looks like
HFMA's published KPI guidance sets the core targets: days in AR ideally 30 to 40, clean claim rate at or above 98% (a figure HFMA attributes to Becker's ASC Review; the 95% floor is Sorso's own), and bad debt or unnecessary write-offs under 3% of total expected collections. MGMA's benchmarking puts first-submission denial rates at 7% to 8% over the past four years, and separately found that 48% of medical group leaders name denials and appeals as their practice's largest source of revenue leakage, which is why denial management stays one of the biggest recoverable costs for outpatient clinics.
From Sorso
Start with eligibility checks when you're chasing denials. They tend to be the cheapest category to fix, since no coder is involved, just a front-desk verification step.
Related terms
Continue with Sorso
How clinic owners typically work with us
Fractional CFO
Strategic CFO for $3M–$50M clinics
Forecasts, location-level P&L, exit prep. Starts at $4,000/mo.
Explore Fractional CFO →Accounting
Healthcare-specialist accounting
Books done right by people who understand clinic finance. Starts at $2,000/mo.
Explore Accounting →Free Assessment
See where your clinic stands
4-minute, 15-question diagnostic. Personalized scorecard emailed to you.
Take the Free Assessment →
Founder of Sorso and a CFA charterholder. Before Sorso, Stan spent 19 years in corporate finance at institutions including UniCredit and Société Générale — managing a $450M loan portfolio and making senior partner at a major mezzanine lender by 29 — then built a fractional CFO firm exclusively for outpatient healthcare clinics.
Want to see how your practice measures up?
Take the 4-minute financial assessment. It is free, and it will show you where your practice is leaking money.