When A/R grows, the usual response is to ask the billing team to work harder. That rarely lasts. A better approach is to change what the team works on and in what order, and to stop the problems that create A/R in the first place.
Start with a clear picture
Pull an aging report by payer and by age bucket: 0–30, 31–60, 61–90, 91–120 and over 120 days. Look for:
- Payers with a large share of older balances.
- Claims with no activity in the last 30 days.
- Denials that were never reworked.
- Patient balances that have not been billed or followed up.
This tells you where the money is and why it is stuck.
Prioritize by value and age
Not every claim deserves the same attention. Work high-value claims first, then claims that are close to a payer’s filing or appeal deadline. Small balances still matter, but batch them so they don’t crowd out larger ones.
A worklist sorted by dollar value and age often achieves more than a long list worked from the top down.
Stop A/R at the source
Much of what ends up in aged A/R started as a fixable problem:
- Eligibility errors that become denials weeks later.
- Clearinghouse rejections that sit unworked.
- Payer requests for records that nobody answers.
- Charge lag, which eats into the time left to fix problems before filing limits.
Fixing these upstream means less A/R needs follow-up at all.
Work denials as they arrive
Denials left for later become aged A/R. Review new denials every week, correct and resubmit what can be fixed, and appeal what should be paid. Track outcomes so you know which payers and reasons cause the most rework.
Use the tools you already have
Most practice management systems and clearinghouses can do more than they are asked to:
- Claim status checks that show which claims are stuck before anyone calls the payer.
- Work queues that route denials by reason to the right person.
- Scheduled aging reports, so the numbers arrive without someone building them.
Automating routine checks frees staff for the calls and appeals that need a person.
Follow up on patient balances
Patient balances are a growing part of A/R. Send clear statements soon after insurance pays, follow up on a regular schedule and offer payment plans for larger balances. Collecting known copays and balances at check-in keeps them out of A/R altogether.
Decide what to do with very old A/R
Claims well past 120 days need a decision. Some can still be corrected or appealed; others are past every deadline. Review them, work what can be recovered and write off the rest with a recorded reason, so your reports reflect reality.
Measure progress monthly
Track days in A/R and the share of A/R over 90 days every month, overall and by payer. If both improve for three months in a row, the process is working. If they don’t, find the step that is holding things up.
If your team doesn’t have time to work older A/R, Ace’s A/R management team can take on the backlog while your staff keep up with current claims.