A/R aging buckets

An aging report lays the A/R balance out by time. Each open balance is placed into a bucket according to how many days have passed since the charge was entered or the claim was first submitted, and the report totals each bucket by payer, by provider or by patient. The newest bucket holds claims still inside a normal payment cycle. Each older bucket holds balances that should have paid by now and have not. The buckets step up in fixed increments of days, but the bucket edges matter less than whether you count from the charge date or the submission date, and whether you make the same choice every month.

The aging report is where follow-up work gets assigned. A balance in the first bucket usually needs nothing but patience. A balance in the second needs a claim status check. Anything older needs a person on the phone or in the payer portal finding out why it has not paid, and anything approaching the payer’s timely filing or appeal deadline moves to the front of the queue. Running the report by payer shows whether one plan is holding everything; running it by provider exposes an enrollment or credentialing gap.

The mistake is working the biggest dollars only. Small old balances are the ones that quietly expire, and a long tail of them is how a practice’s A/R comes to look healthy on average while a real share of it is already uncollectable. Work the oldest buckets to zero, in deadline order, not in dollar order.