What’s the Ideal PC Ratio?

The ideal PC Ratio is 95% or higher, indicating that a practice collects nearly all contractually allowed revenue. A below-mentioned ratio suggests underpayments, billing inefficiencies, or high denial rates.

Can PC Ratio Be Higher Than 100%?

No, a PC Ratio over 100% is a red flag for billing errors, miscalculations, or incorrect contractual adjustments. This often signals overpayments, incorrect write-offs, or improper revenue recording, requiring an audit to identify discrepancies.

How Often Should PC Ratio Be Monitored?

PC Ratio should be monitored monthly or quarterly to track billing efficiency and revenue trends. Regular reviews help identify declining collections, payer issues, or coding errors, allowing proactive adjustments to maintain financial stability.

What is PC Ratio in Medical Billing? Definition, Calculation & Optimization

The PC Ratio (Provider Contractual Ratio) is a key financial metric in medical billing that measures payments received against contractual obligations. It helps healthcare providers assess revenue cycle efficiency, optimize payer contracts, and reduce claim denials. What Is the PC Ratio in Medical Billing? PC (Provider Contractual) Ratio The PC Ratio represents the percentage of … Continue reading What is PC Ratio in Medical Billing? Definition, Calculation & Optimization

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