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How to Read Your Own A/R Aging Report

An aging report read by bucket hides the story. Read by payer and by date of service, it names the specific breakdown causing the balance.

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2 min read · by White Glove Medical Billing
A folded paper map opened to show one region in detail

Most practices look at the aging as five columns of totals, note that the last one is bigger than they would like, and close it. The report contains far more than that, but not in the default view.

Read it by payer first

The aggregate is an average of very different behaviours. Split by payer and the picture usually resolves immediately: one or two payers account for most of the aged balance, and their reasons differ.

Aged workers compensation is often normal — those claims run on longer cycles. Aged commercial at the same age is a problem. The aggregate treats them identically and tells you nothing.

Then by date of service, not posting date

Date of service is what filing deadlines run from. An aging built on posting date can show a claim as young when its window is nearly closed, which is exactly the claim you most need to see.

Then split insurance from patient

They age for different reasons and require different work. Insurance A/R ages because something failed — a denial, a rejection, a coverage problem. Patient A/R ages because collection is slow, which is a different discipline with different tools.

Combined, they mask each other. A practice with healthy insurance A/R and a growing patient balance looks the same in aggregate as the reverse, and the fixes have nothing in common.

The three questions to ask each month

  1. Which payer holds the most aged balance, and why that one?
  2. What share of the over-90 bucket is still inside a filing or appeal window?
  3. How much of what is left is genuinely uncollectable and should be written off so the number stops lying?

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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