Clean-claim benchmark
Accepted on first submission.
Source: MGMA / Conifer KPI guide
General RCM benchmark — not BH-facility specific.
Industry benchmarks & Axis measurement standards
Industry benchmarks
& Axis measurement standards.
Every claim is sorted, measured, and worked to a defined standard. These are the figures we hold each file to, drawn from the published industry benchmarks below. Axis establishes each client's baseline during onboarding and reports performance using defined revenue-cycle measures.
Read this first
Published context,
not Axis results.
MGMA · PREMIER · EXPERIAN
Named third-party benchmarks
Industry context
The numbers we manage against.
The figures below are published industry benchmarks and survey findings — not Axis client results. 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: MGMA / Conifer · Experian 2025
Varies by setting, payer, specialty & method.
Optimal days in A/R
General-practice benchmark.
Source: MGMA / Conifer KPI guide
Institutional behavioral health may differ.
Optimal net collection rate
95% minimum benchmark.
Source: MGMA / Conifer KPI guide
Use only with a defined, consistent calculation.
Not Axis results. Every figure here is published by a named third party (MGMA/Conifer, Premier, Experian) for context — not an Axis IRG client outcome, and not specific to every level of care. Axis client results are published only after the period closes, the methodology is documented, and the client verifies the result or approves an anonymized study.
Why denial work matters
Denials are expensive — and often reversible.
The economics of denial work explain why we prioritize the highest-value, most-winnable claims first. These are published provider-survey findings, provided for context.
Initial denial rate
Premier-surveyed provider group.
Source: Premier survey
Surveyed providers — not BH-specific.
Denials overturned & paid
After provider review & appeal.
Source: Premier survey
Survey finding — not an Axis appeal rate.
Avg. cost to contest a denial
2025 report, 2023 expense data.
Source: Premier
Provider-survey estimate; actual costs vary.
About these figures: The benchmarks and survey findings above are published by the named third parties and are provided for context. They are not Axis IRG client outcomes and are not specific to every behavioral-health level of care.
What Axis 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. Client results are published only after clients verify them.
- 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.
Disclaimer: Published benchmarks are provided for context and are not Axis client outcomes.
Behind every score
Behind every score is a method.
Payer intelligence, scoring logic, and a documented framework decide how each denial gets prioritized and worked back to payment. Every measure above is baselined, dated, and reviewed as your outcome data grows.
Every file is measured against a standard and worked in priority order.
Methodology & research
How we decide what a claim is worth.
Our methods are written down, dated, and authored — the diagnostic framework, the scoring logic, and the payer intelligence behind every prioritization decision. Every open claim gets a recoverability score, and the highest-value, most-winnable claims get 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 a Premier provider survey found initial denials running closer to 15%. Neither figure is specific to behavioral health. Your number can land somewhere else entirely because of authorization intensity, payer mix, network status, and level of care, so read the range as context rather than a grade.
Are these numbers Axis's actual client results?
No. Every figure on this page comes from a named third party (MGMA/Conifer, Premier, or Experian) and is there for context, not as a client outcome. Axis client results get published only after the period closes, the methodology is documented, and the client verifies the result or approves an anonymized study.
Is it worth appealing denied claims, or should we just write them off?
Often, yes: in a Premier provider survey, 54.3% of denials were overturned and paid after provider review and appeal. Premier separately puts the average cost of contesting one at $57.23, a provider-survey estimate, so actual costs vary. Those economics are why we prioritize the highest-value, most-winnable claims first.
What net collection rate should we be aiming for?
Optimal net collection runs 97–99% in the MGMA/Conifer KPI guide, with 95% as the minimum benchmark. Just make sure the number rests on a defined, consistent calculation before you compare against it. The same guide puts the clean-claim benchmark at 98% accepted on first submission and optimal A/R at 30 to 40 days. Keep in mind that A/R figure is a general-practice benchmark, and institutional behavioral health may differ.
How do I find out how my numbers actually compare?
Send us a little context and we'll baseline your numbers against these same measures, then show you which claim issues are worth correcting now and what they're likely worth. It's a focused diagnostic, not a sales call. After that, the baseline gets set during onboarding and reported each period using defined revenue-cycle measures, aligned to HFMA MAP Keys where available so results stay comparable.
Want this baseline on your book?
Start with a billing review.
Send a little context and we'll baseline your numbers against these measures — then show you which claim issues are worth correcting now, and what they're likely worth. A focused diagnostic, not a sales call.
Last updated: July 5, 2026