My collection rate is 98-99% however, my medicare charges are one dollar above what they will pay therefore when Medicare pays us in full we know we need to increase our charges. I am in a retirement community and have 90% very complex medicare patients. When my Medicare charges where much higher than what Medicare would pay, i kept getting people trying to pay me the difference which i legally can not accept. It became much easier to charge what they will pay. It also made a better impression on the patients that I was not trying to charge a large fee.