BH RCM Outsource ROI Calculator — 2026 Model
Every BH/ABA/SUD CFO should model outsource ROI before signing. Here’s the exact math framework.
Step 1 — Baseline Metrics
- Current annual net revenue: $ _____
- Current denial rate: ____%
- Current days-in-AR: ____
- Current in-house billing team FTE + burdened cost: $ _____
Step 2 — Recovery Assumptions
- Denial-rate reduction target: -50% (12.3% → 5.7% is realistic)
- Cash acceleration from AR days reduction: ~2-3% of revenue as working capital
- MHPAEA parity recovery: 12-18% of BH commercial denials
- CO-16/CO-197 prevention: $60K-$250K/yr per multi-site
Step 3 — ROI Math (Example $70M BH)
| Line item | Value |
|---|---|
| Annual revenue | $70M |
| Current denial rate 12.3% | $8.6M annual denied |
| Recoverable at 50% reduction | $4.3M/yr |
| Outsource fee @ 5.5% | $3.85M/yr |
| Net ROI year 1 | +$450K + AR acceleration |
| Net ROI year 2+ | +$1M-$2M/yr sustained |
Case Study Match
12-site BH $70M rev. 90-day cash recovery: $1.04M. Annualized: $2.8M+ sustained. Full case study.
Free 30-day ROI audit · Pricing 4-8%
– KD, Revenant Care