Analytics
KPI definitions
ArkCloud calculates each revenue-cycle rate one way, from one definition, wherever it appears. KPIs are fixed: you cannot add your own, set targets or configure alerts.
Written for: Revenue cycle managers · Finance · Analysts
The definitions
| Field or control | What it means |
|---|---|
| Denial rate | Claims denied ÷ claims adjudicated (paid, partly paid, denied or under appeal) in the period. |
| First-pass yield | Claims paid without a denial ÷ claims adjudicated in the period. |
| Gross collection rate | Payments ÷ charges, for the same period. Always below 100% when contracts discount charges. |
| Net collection rate | Payments ÷ (charges − contractual adjustments), for the same period. |
| Liquidation rate | Collected ÷ (open balance + collected), for the period. |
| Days in A/R | A/R balance ÷ average daily charges over the trailing period. |
| Denial recovery rate | Denied amount recovered ÷ denied amount, for denials raised in the period. |
| Appeal rate | Denied claims adjudicated in the period that have at least one appeal ÷ denied claims adjudicated in the period, per denial code and category. Blank when there were no denials. |
| On-time installment rate | Installments paid on or before their due date ÷ installments paid, for the payment plans in the group. |
| Clearinghouse rejections | Claims turned away by the clearinghouse before a payer decided on them, counted once each. Shown beside the denial rate, never inside it. |
The RCM Insights screen (Leadership Analytics → Insights → Benchmarks) lists your own values against these definitions, with the formula beside each. A dash means there was nothing to measure in the period, not zero.
Not configurable
There is no screen for defining a KPI, setting a target or range, or raising an alert when a figure crosses a threshold. The Goals tab on the RCM Insights screen lists goals already on file and has no way to create one. Clean-claim rate, point-of-service collection rate and cost to collect are not calculated. Earlier versions of this page described KPI configuration as available.