For the insured side of the practice, the revenue cycle runs from a submitted claim to a paid one — and money leaks at every step. A claim denied for a coding or eligibility issue, a partial payment never followed up, a balance aging past 90 days: each is billed revenue that may never land in the bank. With vision and medical claims spread across several payers, even a modest denial rate adds up. This dashboard makes the whole pipeline visible — billed, collected, denied, and aging.
What this dashboard answers
The Collections & Denials page answers the biller's headline questions: what share of what we billed did we collect, and what share of claims is being denied? It shows total billed, net collected, net collection rate, and denial rate, with collection rate and denial rate ranked by payer and a monthly billed-vs-collected trend. The AR Aging page focuses on the at-risk dollars — open AR balance and clean-claim/first-pass rate, open AR by aging bucket, a stacked breakdown of claim status (Paid, Denied, Pending, Partial) by payer, and a per-payer table tying claims, billed, collected, collection rate, denial rate, and open balance together.
The metrics that matter
Net collection rate is dollars collected over dollars billed — a sum over a sum — and it's the truest measure of revenue-cycle health because it reflects what actually arrives, not what was charged. Clean-claim (first-pass) rate is the efficiency metric: the higher it is, the less rework the billing team does. Denial rate read next to its payers shows where the friction lives, and open AR by aging bucket is the early-warning line — the older a balance, the less likely it ever pays.
Why the data is trapped across the systems
Claim submission, status, payments, and balances live in the EHR/PM claims module and the clearinghouse feed — RevolutionEHR, Eyefinity/OfficeMate, Compulink, Crystal PM, My Vision Express. The raw data is there, but turning it into a managed AR view requires classifying claim status, bucketing balances by age, and computing collection and denial rates by payer and month — reporting that the billing screens rarely assemble in one place. So practices often know their total collections but can't see which payer is denying, which month is slipping, or how much is quietly aging toward write-off.
How to read it
Read net collection rate first as the headline, then read denial rate by payer to find where claims are failing — a payer with a high denial rate is usually a fixable process issue (eligibility, authorization, coding). Open AR by aging bucket is the urgency map: dollars in the 90+ bucket are the ones to work before they're lost. Clean-claim rate tells you whether the leak is at submission or at follow-up. The sample uses fully synthetic claim data, so there's no patient or financial information in the report.
Metrics it tracks
| Metric | What it means |
|---|---|
| Total Billed | Dollars billed across all claims. |
| Net Collected | Dollars collected across all claims. |
| Net Collection Rate | Dollars collected divided by dollars billed (a SUM-over-SUM ratio). |
| Clean-Claim / First-Pass Rate | Claims paid on first submission divided by all claims (SUM over SUM). |
| Denial Rate | Denied claims divided by all claims (SUM over SUM). |
| Open AR Balance | Unresolved balance on still-open claims (billed minus collected, zero on fully paid claims). |
Used by: Billers, billing managers, and owner-ODs
Frequently asked questions
What's a good net collection rate for an optometry practice?
Healthy practices collect the large majority of what they bill; a rate dragging below that points to denials, underpayments, or write-offs. It's a better health measure than gross charges because it reflects what actually lands in the bank — and reading it by payer shows where the leak is.
What is clean-claim or first-pass rate?
It's the share of claims paid on first submission without rework. A high first-pass rate means the billing team spends less time reworking and resubmitting, and it's one of the clearest signals of how efficient the front-end of the revenue cycle is.
Why does AR aging matter so much?
Because the older a balance gets, the less likely it ever pays — payers have filing limits and patient balances go cold. Watching open AR by aging bucket lets the billing team work the most at-risk dollars, especially the 90+ bucket, before the window closes.
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