Resources
Direct answers to the questions practice owners, administrators, and billing companies ask about aged medical and dental accounts receivable. Each article leads with the answer, shows the numbers in a table, and cites its sources.
A/R recovery Aged, unworked, and legacy receivables and how they are recovered.
What is aged medical A/R?
Aged medical accounts receivable (A/R) is money owed to a healthcare practice for services already rendered that has remained unpaid beyond its normal payment period. Practices commonly track A/R in 0–30, 31–60, 61–90, 91–120, and 120+ day buckets, measured from the date of service or the claim date.
Is 120+ day medical A/R still recoverable?
Yes. A meaningful share of insurance claims over 120 days is still recoverable, provided each claim is inside the payer's timely-filing or appeal window. Medicare allows one calendar year from the date of service to file and 120 days from the initial determination to appeal; commercial windows are shorter. The first job is sorting the 120+ bucket into claims that are alive, claims that are dying this month, and claims that are dead.
How to recover old medical insurance claims
Old medical insurance claims are recovered in five steps: verify the claim's status with the payer, classify why it is unpaid, check the filing and appeal deadlines, take the action that matches the reason (correct and resubmit, appeal with documentation, or dispute an underpayment), and track the claim until the payer remits or issues a final determination.
Denials Denial categories, appeal deadlines, and what is still recoverable.
Denial recovery vs. A/R recovery: what is the difference?
Denial recovery is the correction, appeal, or dispute of claims a payer has refused to pay. A/R recovery is broader: it works every unpaid insurance claim past its normal payment period, which includes denials but also claims never received, claims with no follow-up, underpayments, and claims stuck in payer processing. Denial recovery is one workstream inside A/R recovery.
Dental A/R Dental insurance receivables and how they differ from medical.
How does dental A/R recovery work?
Dental A/R recovery works aged dental insurance claims claim by claim: confirming status with the carrier, supplying the radiograph, narrative, or charting the plan asked for, resolving coordination-of-benefits and frequency-limit denials, disputing PPO underpayments and downgrades, and rebilling medical plans correctly for cross-coded oral surgery. It follows the same verify, classify, act, track process as medical A/R recovery, but the denial reasons are mostly documentation and benefit rules rather than medical necessity.
Revenue cycle Benchmarks, aging reports, and metrics practices actually use.
What percentage of medical A/R should be over 90 days?
A commonly used target is to keep insurance A/R over 90 days below 15–20% of total A/R, and A/R over 120 days below roughly 10–12%. Well-run specialty practices often run lower. These are widely used rules of thumb rather than a regulatory standard; MGMA DataDive and HFMA MAP Keys are the benchmark sources practices compare against.
Medical A/R aging report: how to read it
An A/R aging report lists every open balance by how long it has been outstanding, usually in 0–30, 31–60, 61–90, 91–120, and 120+ day buckets. Read it by separating insurance from patient balances, cutting the 90+ day insurance balance by payer and by denial reason, and flagging claims with no follow-up activity, which are the ones most likely to be lost.
90-day vs. 120-day A/R: what practices should prioritize
Prioritize by deadline first, recoverability second, and balance third, not by aging bucket. The 91–120 day bucket usually yields the most recovered dollars per hour because its appeal windows are still open. The 120+ day bucket jumps the queue only for claims within 30 days of a filing or appeal limit; the rest of it is worked after the 91–120 bucket.
Practice management Decisions owners and administrators face about old A/R.
What happens to A/R when you switch billing companies?
When a practice switches billing companies, the claims already submitted but not yet paid usually lose their owner: the outgoing vendor stops working them once notice is given, and the incoming vendor is paid on new charges. Unless the transition agreement assigns responsibility for the run-out A/R, those claims age until they cross payer deadlines.
Should you outsource aged A/R?
Outsourcing aged A/R makes sense when the 90+ day insurance balance is large enough to justify a contingency fee (often $250,000 or more), the billing team cannot work it without letting current claims slip, and the queue is racing payer deadlines. Keep current billing in-house or with your existing vendor; outsource only the aged queue, on a contingency fee tied to recovered dollars.
How much is your old A/R actually worth?
Old A/R is worth the share of it that is still inside payer deadlines and has a valid recovery path, minus contractual adjustments already baked into the billed amount. On a typical specialty-practice queue, roughly half of the 90+ day insurance balance is actionable and a portion of that is recovered; the exact figure depends on payer mix, denial mix, and how long the queue sat untouched.
When should a medical practice write off a claim?
A medical practice should write off an insurance claim when it is past both the timely-filing limit and every appeal window with no proof of timely filing, when the balance is a genuine contractual adjustment, or when the documented cost of working it exceeds its expected recovery. Write off claim by claim with a reason code, never by aging bucket.