Clean-claim benchmark
Accepted on first submission.
Source: Conifer KPI guide
General RCM benchmark, not BH-facility specific.
Benchmarks
Industry benchmarks
& HRI measurement standards.
These are the published industry figures we measure against, with their sources below. HRI sets each client's baseline during onboarding and reports against defined revenue-cycle measures.
Read this first
Published context,
not HRI results.
CONIFER HEALTH · PREMIER
Named third-party benchmarks
Industry context
The numbers we manage against.
The figures below are published industry benchmarks. Behavioral-health facility performance can differ because of authorization intensity, institutional claim requirements, payer mix, network status, and level of care.
Industry denial-rate range
Published average range.
Source: Conifer KPI guide
Varies by setting, payer, specialty & method.
Optimal days in A/R
General-practice benchmark.
Source: Conifer KPI guide
Institutional behavioral health may differ.
Optimal net collection rate
95% minimum benchmark.
Source: Conifer KPI guide
Use only with a defined, consistent calculation.
Why denial work matters
Denials are expensive, and many are overturned.
Both facts shape the order in which we work denied claims.
Source record, checked August 2026: Conifer Health KPI definitions and ranges · Premier 2024 provider survey · Premier 2025 claims-adjudication report. Figures come from different samples and should not be combined into a single performance promise.
What HRI measures
A baseline you can see, and measures that hold up.
Definitions for the measures we baseline at onboarding and report each period, aligned to HFMA MAP Keys where available, so results stay comparable.
- Clean-claim rate
- Accepted on first submission, no rework.
- Clearinghouse rejection rate
- Rejected before payer acceptance.
- Payer acceptance rate
- Accepted into adjudication.
- Initial denial rate
- First-pass denials, by volume & dollars.
- A/R days
- Average age of receivables.
- A/R over 90 days
- Share of receivables aged past 90 days.
- Denial-to-appeal time
- Days from denial to appeal filed.
- Denial-to-resolution time
- Days from denial to final resolution.
- Appeal overturn rate
- Resolved in the provider's favor, by $ & volume.
- Net collection rate
- Collected vs. expected after adjustments.
- Underpayment identified
- Dollars found below contracted rate.
- Underpayment recovered
- Dollars recovered against contract.
- Authorization lapse rate
- Services exposed by auth gaps.
- Timely-filing exposure
- Claims at risk of filing-deadline loss.
- Expected collectible value
- Supportable amount per claim.
- Work-queue value & closure
- Queue value and reason work closed.
Methodology & research
How we decide what a claim is worth.
Our methods are written down and dated: the diagnostic framework, the scoring logic, and the payer intelligence behind every prioritization decision. Every open claim gets a recoverability score, and the score decides what gets worked first.
Read the methodology →- 01Payment likelihood
- 02Dollar value
- 03Payer behavior
- 04Effort to resolve
Reading the numbers
Common questions about these benchmarks.
What's a normal denial rate for a behavioral health facility?
Published industry averages put denial rates in the 5–10% range, and that range is not specific to behavioral health. Authorization intensity, payer mix, network status, and level of care can put your number somewhere else entirely. Read the range as context rather than a grade.
Are these numbers HRI's actual client results?
No. Every figure on this page comes from a named third party (Conifer Health or Premier) and is there for context, not as a client outcome. HRI results are published from our own remittance and deposit records once the money has cleared, with the client unnamed.
Is it worth appealing denied claims, or should we just write them off?
Often, yes. Premier's 2025 report found about 70% of denials were overturned and paid, but only after multiple rounds of review. For private payers, its 2024 survey put the figure at 54.3%. Premier puts the average cost of contesting one claim at $57.23, a provider-survey estimate, so actual costs vary. Those economics are why we score a denial before we spend time contesting it.
What net collection rate should we be aiming for?
Conifer Health's KPI guide puts optimal net collection at 97–99%, with 95% as the minimum benchmark. Compare only against a number calculated the same way every period.
How do I find out how my numbers compare?
Send a little context with your billing review request, and we'll baseline your numbers against these same measures.
Want this baseline on your book?
Start with a billing review.
We'll show you which claim issues to correct first and what they're likely worth.
Last updated: October 25, 2026