A good A/R aging percentage helps medical practices understand how much outstanding revenue remains unpaid and whether their billing team is following up on claims effectively. For healthcare providers, a growing percentage of accounts receivable (A/R) over 90 days can indicate unresolved denials, delayed claim submission, payer processing problems, underpayments, or ineffective follow-up.
A commonly used healthcare benchmark is to keep A/R older than 90 days below 10% of total A/R, where appropriate for the practice and measurement method. However, this is a reference point rather than a universal standard. Your specialty, payer mix, patient responsibility, contract terms, and reporting methodology all affect what a healthy A/R aging profile looks like.
If your practice has a high 90-day A/R percentage, recurring unpaid claims, or an increasing backlog of outstanding balances, an A/R aging review can help identify where revenue is getting stuck. The Medicator’s provides A/R management services and revenue cycle management services to help medical practices organize outstanding accounts, investigate payment delays, and strengthen follow-up workflows.
What Is a Good A/R Aging Percentage for a Medical Practice?
A good A/R aging percentage depends on how quickly your practice submits claims, how payers process them, and how consistently outstanding balances are worked. One of the most useful indicators is the percentage of total accounts receivable that remains unpaid for more than 90 days.
For example, if a medical practice has $100,000 in total A/R, less than $10,000 in A/R older than 90 days would meet a 10% reference threshold. The calculation should use a consistent definition of total A/R and the same reporting date for both amounts.
A practice should review more than the overall percentage. Break down aged A/R by payer, provider, service date, claim status, denial reason, and patient responsibility. This helps distinguish normal payment delays from claims that require correction, an appeal, payer escalation, or another collection action.
If your practice is struggling to understand why balances remain unpaid, medical billing audit services can help assess claim workflows, payment posting, coding issues, and follow-up processes.
What Is an A/R Aging Report in Medical Billing?
An A/R aging report is a financial report that organizes unpaid balances according to how long they have remained outstanding. Medical practices use this report to identify overdue insurance claims, unpaid patient balances, unresolved denials, and accounts that require additional follow-up.
An accounts receivable aging report commonly separates outstanding balances into these categories:
| A/R aging category | What it indicates | Recommended action |
|---|---|---|
| 0–30 days | Recently submitted or relatively current balances | Monitor claim status and payment timing |
| 31–60 days | Balances requiring closer attention | Check payer processing and missing information |
| 61–90 days | Increasingly delayed receivables | Investigate claim status, rejections, and denials |
| 91–120 days | Aged balances that may require escalation | Prioritize account-level follow-up and appropriate appeals |
| 120+ days | Long-outstanding receivables | Review recovery options, filing limits, documentation, and collectability |
These categories are useful starting points, but practices should adapt their follow-up priorities to payer requirements, contractual deadlines, and the nature of each balance.
An aging report should lead to action rather than simply record outstanding money. If your team cannot identify the reason for nonpayment or the next step for each account, consider reviewing your A/R management workflow.
How to Calculate the A/R Aging Percentage
The A/R aging percentage measures the share of total outstanding accounts receivable that falls within a particular aging category.
A/R aging percentage formula:
A/R aging percentage = (A/R balance in the selected aging category ÷ Total A/R balance) × 100
To calculate the percentage of A/R older than 90 days, divide the total balance in the 91–120-day and 120+-day categories by total A/R, then multiply by 100.
Example: Calculating the 90-Day A/R Percentage
Suppose your medical practice has the following outstanding receivables:
| Aging category | Outstanding balance |
|---|---|
| 0–30 days | $45,000 |
| 31–60 days | $25,000 |
| 61–90 days | $20,000 |
| 91–120 days | $6,000 |
| 120+ days | $4,000 |
| Total A/R | $100,000 |
The A/R balance older than 90 days is $10,000.
Using the formula:
($10,000 ÷ $100,000) × 100 = 10%
In this example, 10% of the practice’s outstanding receivables are older than 90 days. The next step is to examine those accounts to determine whether they involve unresolved denials, payer delays, missing documentation, patient balances, or other issues.
The percentage alone does not establish whether the entire balance is collectible. A claim-level review is necessary to decide which follow-up action is appropriate.
For help evaluating billing performance and identifying process gaps, explore practice analysis services.
What Does A/R Aging Mean for Healthcare Providers?
A/R aging describes how long money owed to a healthcare practice has remained unpaid. The balance may come from insurance claims, patient responsibility, or other receivables, depending on how the practice prepares its report.
In medical billing, A/R aging helps practice managers answer important operational questions:
- Which insurance payers have the largest outstanding balances?
- How much revenue remains unpaid beyond 60 or 90 days?
- Are claims being submitted within required filing deadlines?
- Which denials have not been corrected or appealed?
- Are payments being posted accurately?
- Is the billing team consistently following up on unpaid claims?
- Which accounts need immediate attention to preserve collection opportunities?
An A/R aging report is most useful when it is reviewed alongside denial trends, days in A/R, payment posting accuracy, and collection performance. A high aged balance may indicate a workflow problem, but the specific cause must be verified before corrective action is taken.
If recurring claim denials are contributing to older balances, review denial rate vs. rejection rate to understand why rejected claims and denied claims require different follow-up steps.
Why Is Your Medical Practice’s A/R Aging Percentage High?
A high A/R aging percentage can develop when claims remain unresolved for weeks or months. The problem is not always the payer. In many cases, the underlying cause begins earlier in the revenue cycle or involves inconsistent follow-up after submission.
1. Unworked or Untracked Medical Claims
Claims can remain unpaid when staff do not regularly check claim status, investigate missing responses, or assign clear responsibility for follow-up. A tracking system should show the claim status, last action, next action, and responsible team member.
2. Unresolved Claim Denials
Denied claims can move into older aging categories when the practice does not identify the denial reason, correct errors, submit supporting documentation, or appeal within applicable deadlines.
A structured denial management workflow helps teams distinguish preventable billing errors from payer disputes and other issues that require separate resolution paths.
3. Eligibility and Authorization Problems
Incorrect insurance information, inactive coverage, missing referrals, or authorization issues can delay reimbursement. Some problems can be prevented before the visit by confirming eligibility and reviewing payer-specific requirements.
Explore eligibility verification services if front-end coverage issues are contributing to claim delays or denials.
4. Coding and Documentation Errors
Claims may require correction when the submitted codes, modifiers, diagnosis information, or documentation do not meet applicable payer requirements. Repeated issues should trigger a review of the underlying workflow rather than repeated corrections to individual claims.
A medical billing audit can help identify recurring coding, documentation, and claim-processing issues that may be contributing to aged receivables.
5. Delayed Claim Submission
When claims are held because of incomplete charge entry, missing information, or internal backlogs, reimbursement can be delayed before the payer even begins processing them. Practices should monitor the time between the date of service and claim submission.
6. Incorrect Payment Posting or Underpayment Follow-Up
A/R reports can be misleading when payments, contractual adjustments, and remaining balances are not posted accurately. Practices should reconcile remittance information against expected reimbursement and investigate discrepancies.
7. Weak Follow-Up on Patient Balances
Patient responsibility can make up a meaningful portion of outstanding A/R. Clear statements, accurate benefit information, and consistent patient communication can help practices manage these balances more effectively.
For practices experiencing several of these issues at once, broader revenue cycle management services can help evaluate the connections between eligibility, claim submission, denial handling, payment posting, and A/R follow-up.
How to Reduce A/R Over 90 Days
Reducing the percentage of A/R over 90 days requires a prioritized plan that addresses existing aged balances while preventing new claims from entering the same backlog.
Step 1: Segment the A/R Aging Report
Separate balances by payer, age, denial reason, claim status, provider, and patient responsibility. This helps identify where the largest balances and most persistent delays are concentrated.
Step 2: Prioritize Accounts by Risk and Action Needed
Start with accounts that have substantial balances, approaching filing or appeal deadlines, pending documentation requests, or a clear path to resolution. Do not prioritize accounts solely by dollar value; deadlines and recovery prospects also matter.
Step 3: Investigate Unpaid Claims
Determine whether each account is awaiting payer processing, needs correction, requires an appeal, has a payment discrepancy, or represents patient responsibility. Record the next action and assign an owner.
Step 4: Resolve Denials and Rejections Correctly
Correct claim errors, provide requested information, or submit appeals when supported by the record and applicable payer rules. Follow the relevant payer deadlines rather than assuming every account can be resubmitted or appealed in the same way.
Step 5: Strengthen Payment Posting and Reconciliation
Compare payments and adjustments with remittance advice and contractual expectations. Investigate unexplained short payments, unapplied cash, and balances that remain open after payment.
Step 6: Establish a Recurring Follow-Up Schedule
Assign follow-up intervals according to payer response times, account status, and filing or appeal deadlines. Review unresolved accounts regularly and escalate cases that remain stagnant.
Step 7: Measure Results Every Month
Compare the percentage of A/R over 90 days with prior reporting periods. Also review total A/R, days in A/R, denial trends, net collections, and the amount of aged receivables resolved during the period.
A structured A/R management service can help practices maintain visibility into aged accounts and coordinate follow-up across outstanding claims.
When Should You Outsource Medical A/R Management Services?
Outsourcing A/R management may be worth evaluating when your internal team cannot keep pace with outstanding claims or lacks the time and resources to investigate older balances consistently.
Consider requesting an A/R workflow review if your practice is experiencing:
- A growing percentage of A/R older than 90 days.
- Large volumes of unpaid or unworked medical claims.
- Repeated denials without consistent resolution.
- Unclear ownership of payer follow-up.
- Limited reporting on payer-specific outstanding balances.
- Unexplained payment discrepancies or underpayments.
- Staff spending excessive time chasing overdue claims.
- Difficulty determining which aged balances remain actionable.
An outsourced medical A/R management company may support claim-status checks, denial follow-up, account prioritization, payment discrepancy review, and reporting. The precise scope depends on the service agreement, available claim information, payer rules, and the practice’s existing workflows.
Before hiring an outsourced A/R management company, ask how it categorizes aging accounts, tracks follow-up activity, reports unresolved claims, handles appeals, and measures performance. Also establish how the vendor coordinates with your internal billing team and how responsibilities are divided.
The Medicator’s offers A/R management services as part of a broader approach to medical billing and revenue cycle support. Practices can also explore medical billing services when they need help with connected billing tasks beyond aged-account follow-up.
How a Medical Billing Company Can Help Improve A/R Aging
A medical billing company can help organize receivables and identify recurring issues that delay payment. The value of that support depends on whether the service includes clear account ownership, consistent follow-up, useful reporting, and a process for addressing root causes.
A practical medical A/R management workflow may include:
- Reviewing aging reports and identifying priority accounts.
- Checking the status of outstanding insurance claims.
- Investigating denials, rejections, and missing information.
- Coordinating corrections and appropriate appeals.
- Reviewing remittance advice and payment discrepancies.
- Tracking follow-up actions and unresolved payer responses.
- Reporting aged A/R trends and recurring barriers to collection.
- Identifying front-end or billing process problems contributing to new aged balances.
Practices evaluating a vendor should look beyond broad promises of faster collections. Request clear information about reporting frequency, workflow responsibilities, account escalation, compliance practices, and how performance will be measured against your baseline.
For a broader review of billing and reimbursement workflows, The Medicator’s also offers revenue cycle management services and medical billing audit services.
Which A/R Aging Metrics Should Medical Practices Track?
A/R aging percentages are more informative when reviewed with other revenue cycle indicators. A single metric rarely explains why payments are delayed or whether a practice’s follow-up process is effective.
| Metric | What it helps you evaluate |
|---|---|
| A/R over 90 days | Share of outstanding receivables in older aging categories |
| Total A/R | Overall outstanding balance at the reporting date |
| Days in A/R | Approximate time revenue remains in accounts receivable, based on the chosen methodology |
| Denial rate | Frequency of claims denied by payers, using a consistent definition |
| Net collection rate | Collection performance against the amount expected to be collected under the chosen methodology |
| Claim submission lag | Time between service and claim submission |
| Aged A/R worked | Whether older accounts are receiving documented follow-up |
| Underpayment trends | Whether reimbursements differ from expected amounts |
Define each metric consistently before comparing results across months, providers, or vendors. Differences in report configuration, included balances, payer mix, and calculation methods can make direct comparisons misleading.
If your team needs help interpreting billing performance, practice analysis services can provide a starting point for reviewing workflow and financial reporting needs.
Request an A/R Management Review for Your Medical Practice
If your practice has a high A/R aging percentage, a growing backlog of unpaid claims, or difficulty determining why receivables remain outstanding, the next step is to investigate the accounts behind the numbers.
The Medicator’s supports medical practices with A/R follow-up, medical billing, denial management, and broader revenue cycle workflows. A review of your current A/R aging report can help identify the categories, payers, and claim issues that deserve closer attention.
Looking for outsourced A/R management services or a medical billing performance review? Contact The Medicator’s to discuss your practice’s current workflow, outstanding receivables, and billing support requirements.
Explore A/R management services or revenue cycle management services to learn more.
