RCM Staffing Calculator

The RCM Staffing Calculator recommends billing and revenue cycle staff ratios for independent practices based on monthly claim volume, specialty, payer mix complexity, and outsourcing model. Output is benchmarked against MGMA Physician Practice staffing norms, which report billing FTE per physician by specialty and practice size.

MGMA staffing benchmarks: the median billing staff ratio for independent practices is 0.5–0.7 FTE per physician for practices using in-house billing. Specialties with high prior authorization burden (orthopedics, cardiology, oncology, behavioral health) typically require 0.7–1.2 FTE per physician. High-volume primary care practices using a clearinghouse with strong auto-posting can often operate at 0.4 FTE per physician. Practices with denial rates above 10% typically require additional FTE allocated to denial follow-up and appeals — approximately 0.1–0.2 additional FTE per physician for every 5 percentage points of denial rate above benchmark.

The calculator separates front-end FTE (eligibility, prior authorization, charge entry) from back-end FTE (payment posting, denial follow-up, AR management) and from management FTE (billing manager, coding oversight). Undestaffing the denial follow-up function is the most common staffing error — it directly drives AR days upward as claims age without action.

• RCM benchmarks — including MGMA staffing norms
• Denial Risk Tool — assess your current performance metrics
• Cash Leakage Calculator