How Outsourced RCM Services Can Help Lift Your NCR
ModMed SVP of RCM Services, Rob Ware, explains why net collection rate is the key metric for practice health
You put in the hours, deliver the care, and submit the claim on time. But a fast submission that sits in a denied queue for 60 days is still a drag on your cash flow.
While it is tempting to focus strictly on claim submission speed or days in AR, ModMed Senior Vice President of RCM Services, Rob Ware, maintains that net collection rate (NCR) is one of the most telling measures of your practice’s financial health. Unlike other metrics, NCR filters out the noise to show you how much of your earned revenue is being collected.
Read on to discover Ware’s additional insights, including how an outsourced revenue cycle management (RCM) team, like ModMed® RCM Services, is designed to help practices improve denial resolution and reduce AR aging. You’ll also learn how AI-assisted workflows designed to surface denial risks before submission can help you collect the compensation that’s rightfully yours.
Why NCR is the metric your practice should care about
Net collection rate measures how much of your earned revenue you actually bring in after adjusting for contractual write-offs. It answers a fundamental question: Of every dollar you’re owed, how much are you getting back?
Other metrics measure activity. NCR measures outcomes.
A practice can submit clean claims on Day 1, maintain a low rejection rate, and still leave significant revenue on the table if denials aren’t worked aggressively and appeals aren’t filed before payer deadlines.
Consider what a shortfall looks like in practical terms. A practice with a 78% NCR is collecting 78 cents of every collectible dollar, leaving 22 cents uncollected. For a practice billing $2 million annually, that hypothetical gap translates to $440,000 in unresolved denials, delayed follow-ups, and aging AR.1
If your practice is consistently tracking below industry benchmarks, it’s likely you have a denial-resolution gap worth investigating.
The resolution gap: Why speed alone doesn’t close claims
Submitting a claim is the first step. Getting paid is the finish line.
When claims age out, appeals windows close, and revenue evaporates — not always from bad coding, but sometimes because no one followed up.
As Rob Ware, Senior Vice President of RCM Services at ModMed, points out, a small billing team can’t realistically track every denial, resubmission, and appeal timeline while handling daily claims. Something gets deprioritized. Usually, it’s the denial work — the exact work that determines your NCR.
“CMS reimbursements haven’t kept up with inflation,” Ware says. “Providers are price takers — they get what payers give them and don’t have the leverage to raise prices, but all their costs are going up.”
The revenue cycle is often the only place left to recover margin. And most practices aren’t collecting everything they’re owed.
What outsourced RCM services do for independent practices
Outsourced RCM means a third-party team handles your billing operations — claim submission, denial management, payer follow-up, and payment posting.
In practice, this looks like denials getting flagged and worked within days, not weeks. Appeals filed before payer deadlines. Patterns in claim rejections identified and corrected before the next batch goes out.
One common concern is visibility. Outsourcing sounds like handing over the keys to your cash flow and hoping for the best. But strong RCM services — particularly those that integrate directly with your existing practice management platform — typically provide clearer financial reporting than a stretched in-house team can produce.
“RCM is the lifeblood of the practice; there’s a lot of fear with the loss of control,” acknowledges Ware. “But with ModMed, they’re working out of the same system the practice is. They’ve got complete visibility — reporting is there to see what’s going on.”
When practices handle denial resolution systematically, NCR could climb. Teams can identify and recover revenue that would have previously aged off the books.
For specialty practices, this advantage deepens. ModMed RCM Services brings teams already familiar with their nuances — coding patterns, payer behaviors, authorization requirements — to accelerate ramp-up.
The future of RCM: AI is changing how denials get worked
Payers are already using AI in prior authorization workflows, and physicians say denials are rising — with the AMA reporting that 75% of physicians have seen prior authorization denials increase over the past five years.
Ware explains, “With AI, we look at historical claims, payer policies, and we can bring a lot of information to bear. All that information’s been out there, but AI allows you to aggregate so much and present it to the biller in a unified way.”
Practices that embrace this shift are well-positioned. AI tools can analyze claim data and flag likely reasons for denial before a claim goes out. They can help identify patterns across hundreds of claims that a human reviewer might not catch until the damage is already done. ModMed’s AI Billing Assistant surfaces denial patterns and routes complex tasks to human agents who identify the root cause, decide how to respond, and act.
The human remains in control. AI raises the alarm; the billing specialist decides what to do with it.
Ware also pointed to a longer-term vision: bringing payer policy intelligence, historical claims data, and National Correct Coding Initiative (NCCI) edits together in a single workflow view — surfacing the right information at the right moment, not just when working on denials, but earlier in the process when discrepancies are far cheaper to fix.
As ModMed builds AI-assisted RCM tools into its platform, practices using them may be better positioned to recover revenue they’ve already earned — an advantage that matters when every percentage of margin counts.
How to know if your NCR needs attention
A healthy NCR falls in the 95%–98% range for most specialty practices. Below that threshold, you might have a resolution gap worth examining.
Three signs your current RCM workflow may be leaving revenue behind:
- Your AR over 90 days is climbing month over month
- Denied claims are being written off instead of being appealed
- Your billing team spends more time submitting new claims than resolving old ones
“For smaller practices, keeping up is more of a challenge,” observes Ware. “If you lose one of two billers, you’re down pretty significantly. Replacing that knowledge in this labor market is still challenging.” That lean build can make it harder to maintain the discipline needed to hold NCR above 95%.
When a key biller leaves, practices lose institutional knowledge about payer quirks, appeal timelines, and the informal rules that kept claims moving. According to Ware, that knowledge gap can show up in your NCR within weeks.
Collect more of what you’ve already earned
NCR reflects your practice’s actual financial health. Submission speed tells you how fast you’re starting the race. NCR tells you whether you’re finishing it.
For independent specialty practices, outsourcing RCM is smart business. You’re putting denial resolutions in the hands of teams who know your coding patterns, understand your payers, and can tell you where your claims stand.
Practices that also add AI-assisted workflows to the mix are poised to compound the advantages. As tools like ModMed’s AI Billing Assistant develop further within RCM workflows, practices that have moved to AI-assisted RCM may be better positioned to recover revenue with less manual effort, and with clearer visibility into where their money stands.
The practices that treat NCR as a lagging indicator are left reacting. The ones that treat it as a diagnostic tool — and invest in tools designed to help move it — are the ones collecting what they’ve earned.
Explore how the more than 2,000 specialists who make up ModMed RCM Services can help your practice improve its NCR.
Frequently asked questions
What is a good NCR for a medical practice?
A net collection rate (NCR) of 95%–98% or above is generally considered healthy for specialty practices. If your practice is tracking below that range, it often signals a denial resolution gap — claims are being submitted but not followed through to payment.
How can outsourced RCM services help improve collections?
Outsourced RCM services can help improve collections by dedicating full-time capacity to denial management, appeal filing, and payer follow-up. In-house billing teams often prioritize new claim submissions over resolving denials, leading to aging AR and written-off revenue. An outsourced team handles resolution systematically, which can lift NCR over time.
What is the difference between NCR and a clean claim rate?
Clean claim rate measures the percentage of claims accepted by the payer on first submission. NCR measures how much of your net collectible revenue you actually receive. A practice can have a high clean claim rate and still have a low NCR if denied claims aren’t worked aggressively. NCR is the outcome metric; clean claim rate is a process metric.
When should an independent practice consider outsourcing RCM?
Common triggers include losing a key biller, rising AR over 90 days, increasing denial rates, or struggling to keep up with new submissions and denial follow-ups. If your NCR has been declining or you don’t track NCR at all, outsourcing can help you recover revenue you might be leaving on the table.
How does AI fit into modern RCM workflows?
AI tools in RCM can analyze historical claim data to flag likely denials before submission, identify denial patterns across large volumes of claims, and help billing staff prioritize which claims need immediate attention. The AI Billing Assistant, for example, surfaces signals that help human agents pinpoint the root cause, decide how to respond, and act. AI accelerates the work — it doesn’t replace the specialist making the final call.
How long does it take to transition to outsourced RCM services?
For practices new to a platform, a typical ramp-up period is 90 days. Leading indicators, such as rejection and denial rates, should stabilize within the first 30–60 days, giving practices early visibility into whether cash flow is on track before revenue is fully realized. Practices already on ModMed’s platform often see a faster transition with less disruption.
Help your practice improve its net collection rate. Start here.
1 Hypothetical numbers for illustrative purposes only. Results may vary based on practice size, product usage, and other factors.
This blog is intended for informational purposes only and does not constitute legal or medical advice. Please consult with your legal counsel and other qualified advisors to ensure compliance with applicable laws, regulations, and standards.
This blog includes “forward-looking statements,” including information about solutions and features that are not yet available. The decision and timing regarding release and development of solutions and features may be subject to change. Actual solutions and features may differ materially from any of those expressed here or in other forward-looking statements. Any purchasing decisions made by you should be solely based on ModMed’s existing solutions and functionality.
