Trust but Verify: The Yin and Yang of RCM Metrics

RCM is all about numbers. Some are more helpful at face value, and others should raise questions. Take A/R Days. If they’re down, that should be a win, right? But it depends. We’ve seen A/R Days drop because someone cleared the decks by writing off a bunch of viable A/R. That might get leadership off your back, but it’s not good revenue cycle management. It’s just optics.

That’s why we always say: trust your KPIs, but verify the story behind them.

The Truth About RCM Metrics

Metrics matter. We track them for a reason. A/R Days, A/R > 90, Net Collection Rate, Denial Rate—they’re all useful signals of how the revenue cycle is performing.

But here’s what we know from doing this work every day: most metrics can be gamed.

You can:

  • Drop A/R > 90 by writing everything off at Day 91.
  • Bump up Net Collection Rate by holding back on adjustments.
  • Improve Denial Rate by simply not posting denials you don’t plan to work.

It doesn’t mean your team is doing anything wrong. Often, it’s the result of pressure to “clean things up” fast, hit a target, or show progress during a reporting cycle. However these practices put you at risk of making the wrong decisions, or thinking everything’s fine when it’s not.

Metrics Need Context and a Counterbalance

No single KPI gives you the full picture. You have to look at them together, and more importantly, ask what’s really driving them.

Here’s what we mean:

  • If A/R Days are trending down, what’s happening with Net Collection Rate?
  • If A/R > 90 is improving, are you also seeing a jump in adjustments or bad debt?
  • If your Denial Rate is low, does this track to your controllable write off patterns?

These kinds of pairings matter. One metric tells you the outcome. The other tells you the cost.

A Real-World Example

One client we worked with had a long-standing policy: write off all A/R at Day 365, but nothing before then. On paper, that sounded clean. In practice, it meant two things:

  • Dollars that were never going to be collected sat in A/R buckets for months, inflating the numbers.
  • At the same time, some viable dollars were being written off the minute they hit 365.

It was a lose-lose—reports looked off, and real cash was getting left on the table.

We helped them rethink their adjustment policy. Instead of a blanket “365-day rule,” the team now writes off dollars once efforts are exhausted and keeps working viable accounts beyond 365. That simple shift freed them to focus on the right dollars, not just the old ones.

The results? Significant collections on accounts older than a year, plus a more accurate view of A/R. At first, A/R Aging went up a little because the automatic 365-day write-off disappeared. But as the new process settled in, A/R Days started trending back down—and the team is now driving real cash on aged A/R.

That’s what balance looks like: metrics that reflect reality, not just a policy.

It’s Not Just a Math Problem

RCM is grounded in mathematics. But there’s also an art to it.

You need people who know what “normal” looks like. People who notice when a metric shifts in a weird way. People who are willing to ask “what changed?” instead of just celebrating a better-looking report.

And you need a culture that values truth over pretty numbers. Otherwise, it’s too easy to measure the wrong things and call it progress.

At Revology, we pair people who get it with technology that surfaces the right signals—and we use both to ask better questions.

What Good Looks Like

Good RCM isn’t about perfect metrics. It’s about honest ones. It’s about using data to inform decisions. And it’s about building a revenue cycle that performs well, and makes sense when you look under the hood.

If you’re rethinking how you track performance—or if something doesn’t feel quite right behind your numbers—we can help.