What your A/R aging is really telling you.

Start with the definition, not the percentage

Before comparing aging, confirm what starts the clock: date of service, first billing date, or another system event. Keep that choice consistent. Confirm whether the report includes payer balances, patient balances, credits, and accounts already approved for adjustment.

A balance-weighted over-90-day share divides dollars older than 90 days by total in-scope A/R dollars at the same cut-off. It is not the percentage of claims denied and it is not a prediction of collectibility.

Separate age from reason

Two accounts can be equally old and need very different work. One may be awaiting a payer response; another may need a corrected demographic field; a third may lack supporting clinical documentation.

• Group no-response claims separately from adjudicated denials.
• Identify accounts awaiting client information or a payer decision.
• Review patient responsibility under the practice’s approved policy.
• Track credits and unapplied cash separately so they do not obscure the balance.

Watch movement between buckets

A lower over-90-day percentage can reflect collections, adjustments, or a larger volume of new charges. Review the change in dollars as well as the percentage and reconcile significant adjustments.

Look at cohorts where possible: what happened to the accounts that were 61–90 days old last month? Movement tells a more useful story than a single snapshot.

Turn the report into a work plan

Agree which accounts are actionable, which deadlines come first, and what information is missing. Assign one owner and a dated next action. Keep the original payer deadline visible even when the next internal review moves.

At the next review, discuss completed actions, newly blocked accounts, and whether the same upstream problem is creating more aging. A report should change the next week of work.