Days in AR is the single clearest vital sign of a practice's financial health. Under 30 is excellent. 30–40 is normal. Above 40, you're financing the payers with your own cash flow - and above 60, something is structurally broken.
Here's the exact playbook we run when a practice hands us bloated AR.
Week 1: Triage by dollars, not by age
Most teams work AR oldest-first. We work it highest-recoverable-dollar first. A $4,000 claim at 95 days beats a $120 claim at 200 days every time. Sort every bucket by balance descending, then filter out anything approaching timely-filing limits - those jump the queue regardless of size.
Weeks 2–3: The payer-call blitz
Call every payer on every high-value claim. Document the call reference number, the rep's name, and the promised action date. Payers respond to persistent, documented follow-up - most "stuck" claims move within two call cycles once someone is actually watching them.
Week 4: Fix the top 3 denial causes
By now your data shows which CARC codes dominate. Fix the top three at the source: eligibility checks, auth workflows, or coding edits. Every recurring denial you prevent is AR that never ages in the first place.
Ongoing: The 3 disciplines that keep AR low
- Daily submission - claims go out within 24 hours of the encounter, always.
- Weekly AR review - 15 minutes with the aging report, flagging anything crossing 45 days.
- Monthly denial huddle - trend the top codes, assign one owner per fix.
When to bring in help
If your team is already at capacity, AR cleanup is the highest-ROI project you can outsource: it's pure contingency work. At 15% of recovered dollars with no recovery/no fee, a cleanup project either pays for itself many times over or costs you nothing.