Accounts receivable (AR) recovery is the work of collecting money your practice has already earned: claims still waiting on a payer and balances still owed by patients. The longer a claim sits unpaid, the harder it is to collect, so a steady, organized follow-up routine is one of the fastest ways to improve cash flow without seeing a single extra patient.
This guide is for practice owners and office managers. It explains how AR ages, how to measure it, eight strategies that bring unpaid claims in faster, when to write a balance off, and when it makes sense to hand the work to a specialist. If you would like help working your AR, you can talk to our team.
How AR ages, and why age matters
Billing systems sort unpaid claims into aging buckets by the number of days since the claim was sent or the service was provided. The usual buckets are 0 to 30 days, 31 to 60, 61 to 90, 91 to 120, and over 120. Most of your money should sit in the first two. Claims in the older buckets are the ones to watch, for three reasons:
- Payers have deadlines for filing, correcting and appealing claims. Once a deadline passes, the money is usually lost.
- Old claims are usually stuck for a reason, such as a denial, missing information or a lost claim. Time alone does not fix those.
- The older a balance gets, the less likely it is to be collected, and the more staff time it takes.
Run your aging report every week, and look at it by payer as well as in total. One slow payer can hide behind a healthy average.
Numbers to track
Three figures tell you whether AR recovery is working:
- Days in A/R: total accounts receivable divided by average daily charges. A common target is under 40 days, and 30 or less is strong.
- Share of AR over 90 days: the percentage of your AR that is more than 90 days old. You want this number to fall.
- Net collection rate: payments divided by what you were entitled to collect after contractual adjustments.
Our guide to medical billing KPIs shows how to calculate each one. These targets are rules of thumb. Compare yourself with your own past results first.
8 AR recovery strategies
1. Work the oldest and largest claims first
Sort your aging report by age, payer and dollar amount. Start with high-value claims that are close to a filing or appeal deadline. A small team that works the right claims first collects more than a large team that works them in the order they appear.
2. Follow up on a schedule
Check the status of unpaid claims every 7 to 14 days, using the payer portal or your clearinghouse, instead of waiting for the end of the month. Record each call or portal check with the date, the person you spoke to and the next step, so the next person does not start from scratch. Our service page on claim submission and follow-up explains how we handle this.
3. Fix the cause of each denial
A denied claim has a reason code. Record it, group denials by payer, code and provider, and fix the pattern instead of only reworking each claim. If one payer keeps denying the same service, the cause is probably a rule or a documentation gap. See our guides to denial management and silent claim denials.
4. Appeal quickly and keep proof
Appeal deadlines vary by payer and plan, so check each contract and put the deadline on your tracking sheet. Keep a template for common appeals, attach the records that support the claim, and keep a copy of what you sent. Have a trained person review every appeal before it goes out.
5. Collect patient balances early
Patients pay a bigger share of the bill than they used to. Collect copays and known balances at check-in, send clear statements soon after the visit, and offer online payment and payment plans. The sooner a patient sees an accurate bill, the more likely it is to be paid.
6. Prevent AR at the front desk
The cheapest AR to recover is the AR that never forms. Verify eligibility before each visit, get prior authorization when it is required, and send clean claims. Our guides on eligibility verification, prior authorization delays and improving your clean claim rate cover each step.
7. Send claims promptly and watch filing deadlines
Claims sent late start the clock late and risk missing the payer’s timely filing limit. Send claims daily, and track the filing limit for each payer so no claim ages out unnoticed.
8. Use reports and automation, with a person in charge
Dashboards, automatic claim status checks and denial alerts save time on repetitive work. Machine learning can flag claims likely to be denied. A trained person should still decide what to appeal, what to correct and what to write off. See AI claim denial reduction and our guide to medical billing workflow optimization.
When to write off a balance
Some balances should not be chased forever. Set a written policy for small balances that cost more to collect than they are worth, for claims that have passed a payer’s filing deadline, and for accounts you have decided to adjust for hardship. Follow your payer contracts and applicable rules, record the reason for every adjustment, and review write-offs monthly. A rising write-off figure is a sign that claims are slipping through earlier steps. Our article on slow AR follow-ups shows how delays turn into losses.
In-house or outsourced AR follow-up?
Many practices handle AR themselves until volume or turnover makes it hard to keep up. Signs it is time for help include:
- Your share of AR over 90 days keeps rising.
- Nobody clearly owns follow-up, so claims wait for whoever has time.
- Denials repeat for the same reasons.
- Staff turnover keeps interrupting the work.
If you decide to outsource, our guide on how to choose a medical billing company lists what to compare. Our AR and denial claim management service covers the follow-up described above.
Where to start
- Pull your aging report and note your days in A/R and your share over 90 days.
- List the top five claims by value in the oldest buckets and work them this week.
- Group your denials by payer and reason code and pick the biggest pattern to fix.
- Set a follow-up routine: claim status checks every 7 to 14 days, with a named owner.
- Review monthly, and set the next target when the numbers improve.
Frequently asked questions
What is a good days in A/R number?
Under 40 days is a common target, and 30 or less is strong. The right figure depends on your specialty and payer mix, so compare yourself with your own past results first.
How often should we follow up on unpaid claims?
Check each unpaid claim every 7 to 14 days. Claims in the older buckets or close to a deadline need attention sooner.
How long do we have to appeal a denied claim?
It depends on the payer and the plan. Check each contract, and track the deadline for every denial from the day it arrives.
Should we outsource AR recovery?
It can make sense when nobody has time to follow up, your older AR keeps growing or staff turnover is high. Keeping it in-house gives you more direct control but puts the staffing and training on you.
Conclusion
AR recovery works when it is routine: a weekly aging report, a follow-up schedule, fast appeals, early patient collections and fixes at the front desk that stop new AR from forming. If you would rather hand it to a team that does it every day, Billing Benefit handles medical billing and coding from registration through collections. Contact us to review your AR.
