Medical Practice Revenue Calculator
Forecast gross and net clinic revenue, modeling patient visit volumes per provider, blended evaluation and management (E/M) reimbursement rates, and claim denial write-offs.
Practice Financial Summary
Medical Practice Net Revenue Model
Net Revenue = [(Patients/Day × Providers × Days × Reimbursement/Visit) + Ancillary Revenue] × (1 - Denial Rate %)- Visit Volume: Daily patient encounters per provider multiplied by clinic operational days.
- Blended Reimbursement: Average collection rate across commercial, Medicare, Medicaid, and cash visits.
- Ancillary Income: In-house clinical laboratories, allergy testing, immunizations, and ultrasound scans.
- Denials & Bad Debt: Industry write-off rate (typically 4%–8%) for unpaid or rejected claims.
Step-by-Step Worked Example
Calculation Steps:
- Annual Patient Visits = 20 × 2 × 240 = 9,600 visits.
- Gross Visit Revenue = 9,600 × $145 = $1,392,000.
- Ancillary Revenue = $4,500 × 12 = $54,000.
- Total Gross Practice Billings = $1,392,000 + $54,000 = $1,446,000.
- Denial & Bad Debt Allowance (5%) = $1,446,000 × 5% = $72,300.
- Net Realized Practice Revenue = $1,446,000 - $72,300 = $1,373,700/year.
- Net Revenue Per Physician = $1,373,700 / 2 = $686,850/physician.
How to Use This Calculator
- 1Enter the average daily patient encounters per clinical provider.
- 2Input the number of full-time equivalent (FTE) clinicians.
- 3Enter your clinic’s average blended reimbursement collection per visit.
- 4Include monthly ancillary testing revenue and estimated claim denial rates.
Assumptions & Limitations
- Assumes consistent scheduling volume without seasonal practice closures.
Frequently Asked Questions
What is the average collection per visit in primary care?
Blended reimbursement rates for outpatient Evaluation and Management (E/M) visits typically range from $110 to $175 per encounter, depending on geographic location, specialty, and payer mix.
What is a clean claims rate in medical billing?
A clean claims rate measures the percentage of insurance claims processed and paid on first submission without rejections or denials. Well-run practices maintain a clean claims rate above 95%.
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