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A/R Over 90 Days Is the Alarm That Matters

Total A/R can look healthy while the tail rots. The percentage over 90 days predicts write-offs months before the write-offs appear.

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2 min read · by White Glove Medical Billing
Fruit at the back of a bowl showing decay the front does not

Days in A/R is an average, and averages hide tails. A practice can hold a respectable average while a growing share of its receivable quietly becomes uncollectable.

Why the 90-day bucket is different

Collectability falls sharply with age. A claim at 30 days is mostly a question of processing. A claim at 120 days has usually failed at something — denied and unworked, rejected and unnoticed, or sitting behind a coverage problem nobody resolved.

And the bucket is close to filing and appeal limits. Some of what sits there is already unrecoverable; it just has not been written off yet, so it still counts as an asset.

The number that leads your write-offs

This is the practical value: aged A/R predicts write-offs one to two quarters ahead. If the over-90 share is climbing, you are watching future write-offs accumulate in real time. By the time they appear as write-offs, the decision was made months earlier by inaction.

How to read it

  • As a percentage of total A/R, not a dollar figure — the dollar figure grows with the practice and tells you less.
  • Segmented by payer. Aged workers compensation is normal. Aged commercial is a problem.
  • Split insurance from patient. They age for different reasons and need different work.
  • Beside the filing deadline, which is the only thing that makes an aged claim urgent rather than merely old.

If you look at one number monthly, look at days in A/R. If you look at two, make the second one this.

Denials Piling Up?

We handle the revenue cycle end to end — coding by certified coders, claim submission, denial management and appeals, and A/R follow-up, with six reported numbers every month.

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