Accounts Receivable (A/R)

Accounts receivable in medical billing represents every dollar a practice has earned but not yet collected — from both insurance payers and patients. A/R is universally tracked in age buckets because the probability of collection drops sharply as a claim ages. A clean claim worked at day 14 collects at 95%+. The same claim sitting untouched at day 90 collects at 50% or less. By day 180 it is usually a write-off. The single most important A/R metric is days in A/R, calculated as total A/R divided by average daily charges. Top-quartile practices keep days in A/R under 35; bottom-quartile sit above 60. The difference between the two is rarely headcount — it is the discipline of the follow-up cadence. Every claim should have five scheduled touch points: day 14 status check, day 30 first follow-up, day 45 escalation, day 60 supervisor escalation, and day 90 final demand. A/R is split into insurance A/R (governed by payer adjudication and contract terms) and patient A/R (governed by practice billing policy and the No Surprises Act for emergency/OON balance billing). Healthy practices keep over-90 percentages below 10% of total A/R; anything above 25% over-90 indicates a serious denial-management or follow-up cadence failure that pulls down the entire collection rate.