Rethinking the revenue cycle: Transforming the metrics that really matter

For patients, billing is often the final chapter in their care journey. But for health systems, it’s just the beginning of a complex, error-prone process, one that’s costing billions in lost revenue and staff burnout.

Behind every claim is a maze of manual workflows, shifting payer requirements, and documentation gaps. Denials pile up, payments stall, and revenue cycle teams, already stretched thin, are left firefighting instead of optimizing.

It’s not just frustrating, it’s unsustainable. According to the Advisory Board, U.S. hospitals lose an estimated $262 billion annually to administrative complexity and revenue cycle inefficiencies.

Revenue cycle leaders are under pressure to do more with less: reduce cost to collect, improve staff retention, and speed up reimbursement. But traditional fixes, like hiring more staff, aren’t enough.

That’s why leading health systems are moving beyond optimization to reimagination. With automation, they’re improving core revenue cycle metrics and transforming the patient and staff experience, from the first eligibility check to final payment.

Let’s explore the metrics that matter most and how automation can move each one forward.

Denial rate: Where revenue stalls out

On average, 10–12% of all claims are denied, and over 40% of those denials are preventable. Most stem from avoidable issues, such as eligibility errors, missing documentation, or lack of prior authorization.

Denials don’t just slow revenue, they also drain staff time. Every denial requires rework, appeals, or write-offs, taxing already strained teams.

Forward-thinking organizations like Austin Regional Clinic are using automation to proactively verify coverage and minimize eligibility-based denials during their digital registration and intake processes, enhancing revenue collection and ensuring patients aren’t delayed in their care. The health system saw an 83% reduction in eligibility and registration-related denials within the first three months of deploying automation, catching issues at the source before they could impact patients or the bottom line.

Authorization turnaround time: Delayed care, delayed cash

Prior authorizations create friction at every step. For staff, they’re time-consuming. For patients, they delay treatment. For finance teams, they stall billing and reimbursement.

Recognizing the impact, CMS is mandating real-time e-prior authorization by 2027 for major payers. But leading health systems aren’t waiting.

By using AI Agents to streamline the authorizations process, Care New England saw an 80% reduction in authorization time, but the benefits don’t stop there. CNE also saw a 55% reduction in authorization-related write-offs, and over 2,000 staff hours saved.

Days in A/R: The hidden strain on cash flow

Every day a claim sits unpaid is a day of missed opportunity. While leading systems aim for less than 40 days in accounts receivable, many exceed that threshold due to denials, delays, and manual follow-ups. According to HFMA benchmarks, A/R timelines are a persistent concern.

Automation shortens the cycle at every step:

• Claims are submitted faster
  
• Denials are appealed instantly
  
• Patient balances are addressed through personalized digital outreach

Health systems using automation have reduced days in A/R by up to 25%, enabling better cash flow forecasting and less reliance on manual follow-up.

Point-of-service collections: Turning conversations into cash

As patient financial responsibility continues to rise, with deductibles and coinsurance making up nearly 30‑40% of care costs, collecting at the point of service is no longer optional for providers.

Yet many front‑desk teams still lack accurate cost‑estimate tools and workflows to accept payment during check‑in. By automating insurance verification ahead of appointments and sending pre-visit payment prompts via text or email, health systems can shift from reactive billing to proactive collection.

Montage Health reported a 2.8% increase in point-of-service cash collections after enabling digital pre-registration and automatic payment options. This isn’t just a revenue enhancement—it’s a trust-builder, offering transparency and control to patients at a time when financial stress often hinders care.

Cost to collect: Efficiency without compromise

According to MGMA benchmarks, most health systems spend 3–7% of revenue on collection activities, including labor, software, and appeals.

With automation, organizations like MUSC Health have reallocated thousands of staff hours, improving productivity without having to cut jobs or hire additional staff. High-volume workflows like copay collections, eligibility checks, and benefit verification are handled instantly.

RCM staff turnover: The cost of burnout

Revenue cycle teams shoulder a heavy burden: navigating ever-changing payer rules, manual processes, and increasing patient financial complexity. Unsurprisingly, burnout is rampant. According to the HFMA, turnover in RCM roles exceeds 30% annually, driving up retraining costs and disrupting performance continuity.

Automation can help alleviate this strain by offloading repetitive, time-consuming tasks like benefit checks and manual data entry. When teams are freed to focus on more strategic or patient-facing work, job satisfaction improves, and so does retention.

As Dayne Hoffman, Revenue Cycle Solutions Lead at Notable, puts it: “When we free up staff from repetitive tasks, we create space for strategy, patient service, and financial optimization. We aren’t looking to replace people, but to unburden them.”

The bottom line: Revenue integrity, reimagined

By automating intelligently, innovative health systems are reducing burnout, accelerating cash flow, and reclaiming revenue that was once lost to friction and inefficiency.

Ready to move your metrics? Request a demo to see how Notable helps health systems transform their revenue cycles.