How Much Revenue Is Your Practice Losing?

Projections based on specialty-adjusted benchmarks from MGMA, AAFP, and HFMA:

• Billing overhead (5% benchmark): Medical Group Management Association (MGMA) reports average RCM costs at 4.8–5.2% of net collections for outsourced billing.
• Denial rates and recovery: Healthcare Financial Management Association (HFMA) data shows average first-pass denial rates of 6–13% depending on specialty, with 65% eventual recovery. We apply a 35% permanent loss factor to denied claims.
• Undercoding: American Academy of Family Physicians (AAFP) research indicates systematic undercoding costs $30,000+ per physician annually. We calculate per-visit deltas based on specialty-specific visit complexity and E/M coding patterns.
• Recovery targets: Sovereign RCM targets a ≤3% denial rate and 70% undercoding recapture based on our multi-agent AI pipeline's documented performance.

Note: These are directional estimates based on published industry data, not guarantees. Actual results depend on your payer mix, coding patterns, and practice operations. Contact us for a personalized analysis using your actual claims data.