Claims and charges: the raw material. Claims are the denominator under almost every rate. Divide charges by claims and watch that average for silent charge-capture drops. Adjustments: where good numbers go to hide. Split contractual from everything else. If timely filing write-offs are coded as contractual, a 94 percent collection rate can look like 100. Net collection rate: receipts divided by charges minus contractual adjustments. About 95 percent is the common comparison point. A green you cannot verify is not a green yet. Denial rate: the front desk number everyone blames on billing. Use first-submission denials and keep rejections and prior auth denials out of it. Insurance A/R over 90: the money quietly becoming a write-off. Break it out by payer. One payer owning most of the old money is a payer problem, not a billing problem. Patient A/R over 90: scored on trend. The biggest factor is when you first tell the patient what they owe. Three actions this week: • Finish your scorecard with a three-month average. Write unknown where you cannot get a number. • Give your lowest vital one owner and one 30-day question. • Put the seven numbers on your monthly meeting agenda, same order, every month. Episode breakdown: The $150,000 nobody bills you for | Your practice's vitals | How the test works | Claims, charges, adjustments | Net collection rate | Denial rate | Insurance A/R over 90 | Patient A/R over 90 | Add it up | Your plan this week