To reduce accounts receivable (A/R) days in medical billing, fix the steps that slow money down before and after a claim goes out. Verify insurance before the visit, send charges within a few days, submit clean claims electronically, follow up on unpaid claims on a set schedule, work denials quickly, and collect the patient’s share at or before the visit. Most practices that bring their A/R days down do it by tightening these basics, not by buying new software. Effective revenue cycle management helps practices identify and address these delays throughout the billing process.
| Days in A/R is the average number of days it takes your practice to collect what it has billed. You calculate it by dividing your total accounts receivable by your average daily charges. The Healthcare Financial Management Association (HFMA) publishes a healthy range of 30 to 40 days.The fastest ways to lower it are: verify coverage early, get authorizations before the service, send charges fast, scrub every claim, follow up on unpaid claims every week, work denials within days, collect patient balances up front, and review your aging report on a schedule. |
This guide explains what A/R days really measure, where the delays come from, and ten practical steps to bring the number down. It also includes a 30-60-90 day plan, a simple way to work an aging report, and the other numbers to watch alongside A/R days.
What Are Accounts Receivable Days in Medical Billing?
Accounts receivable is the money owed to your practice for services you have already provided. It includes what insurance companies owe you and what patients owe you. Days in A/R turns that dollar figure into time. It tells you how many days of billing are sitting unpaid at any moment.
A lower number means you are getting paid faster. A higher number means cash is stuck somewhere between the exam room and your bank account.
How to calculate days in A/R
The formula is simple.
| Formula Days in A/R = Total accounts receivable ÷ Average daily chargesAverage daily charges = total charges for a set period ÷ number of days in that period. |
Here is an example. Your practice billed $450,000 over the last 90 days, so your average daily charge is 5,000(450,000 ÷ 90). Your total A/R today is $180,000. Divide $180,000 by $5,000 and you get 36 days in A/R.
| Note Sources use slightly different periods for the average daily charge. HFMA’s published method uses gross charges from the previous 12 months divided by 365. Many practices use the last 90 days because it reacts faster to change. Either works. Pick one method, write it down, and use it every month so your trend is reliable. |
What is a good number of A/R days?
HFMA’s published guidance says days in A/R should fall between 30 and 40. It also gives two related targets: A/R older than 90 days should be under 10% of your total A/R, and self-pay A/R older than 90 days should be under 30%.
Your own best number depends on your specialty, payer mix, and how complex your claims are. A surgical practice with large claims and prior authorizations may run longer than a practice that bills mostly routine office visits. That is why your trend over time matters more than any single benchmark. If your number is rising month after month, something in your process has changed.
Why A/R days matter to your practice
Every day of A/R is money you have earned but cannot spend. It also gets harder to collect as it ages. A claim that is 30 days old usually needs a quick status check. A claim that is 120 days old may need an appeal, a corrected claim, or may already be past the payer’s filing deadline. Medical Economics has noted that patient balances left to age beyond 90 days become much harder to recover.
| Why this matters A high A/R days number is a symptom, not the disease. It tells you that a step in your billing cycle is slow, but not which one. The aging report and denial reports show you where to look. |
How to read your aging report
Your aging report breaks A/R into time buckets based on how long each balance has been open. It is the most useful report for deciding what to work first.
| Age bucket | What it usually means | What to do |
| 0 to 30 days | Normal processing time for most payers | Check status only if the payer usually pays faster |
| 31 to 60 days | Claim may be stuck, pended, or lost | Call or check status online; fix and resend if needed |
| 61 to 90 days | Likely a denial, missing information, or underpayment | Work every claim; file corrected claims or appeals |
| 91 to 120 days | High risk of becoming uncollectible | Escalate; check filing and appeal deadlines |
| Over 120 days | Often denied, appealed, or past filing limits | Decide to appeal, bill the patient, or write off |
Where the Time Goes: Why A/R Days Run High
A/R days are the sum of many small delays. Money moves through six stages, and a slowdown at any stage adds days to your number. Here is where the delays usually hide.
| Stage | What slows it down | Typical fix |
| 1. Before the visit | Wrong insurance, expired coverage, missing authorization | Verify eligibility and get approvals first |
| 2. Charge capture | Late or missing charges, unsigned notes | Set a same-day or next-day charge rule |
| 3. Claim submission | Batching claims, paper claims, errors found late | Submit daily and scrub every claim |
| 4. Payer processing | Pended claims, requests for records | Track status and answer requests fast |
| 5. Denials | Slow rework, missed appeal deadlines | Work denials in days and fix root causes |
| 6. Patient balances | No estimate, late statements, no payment options | Collect at or before the visit |
The payer clock: what Medicare allows
Part of your A/R days is simply waiting, and that wait has rules. Under Medicare, a clean electronic claim cannot be paid before the 14th day after it is received, and a clean paper claim cannot be paid before the 29th day. Medicare must pay or deny a clean claim within 30 days, and interest starts after that. Commercial payers follow their own contracts and state prompt-payment laws, which vary by state.
| Note This means a practice cannot realistically get Medicare payments faster than about two weeks, and that paper claims add roughly two extra weeks right away. Your goal is not to beat the payer’s clock. Your goal is to make sure nothing on your side adds extra days on top of it. |
10 Ways to Reduce A/R Days in Medical Billing
These steps follow the claim from scheduling to payment. Start with the ones where your reports show the biggest delays.
1. Verify eligibility and benefits before every visit
A claim sent to the wrong payer, or for a patient whose coverage ended, will be denied and then reworked. That rework is one of the most common reasons for claiming age. Check eligibility when the visit is booked and again close to the visit date, using the payer portal or a real-time check through your clearinghouse. Ask every patient whether their insurance has changed, and scan the front and back of the card at each visit.
Also confirm the patient’s responsibility codes like deductible, copay, and coinsurance during this check. You will need those numbers later when you collect the patient’s share.
2. Get authorizations and referrals before the service
A missing authorization turns a payable claim into a denial. Keep a short list of which services need approval for your top payers, and request it as soon as the service is scheduled. Before the visit, confirm that the approved code, dates, units, and provider match what you plan to bill. Put the authorization number in the correct field on the claim. Knowing the different authorization types in healthcare can help staff identify which approvals are required before services are provided.
3. Capture charges and send claims fast
The time between the visit and claim submission is called charge lag, and it adds directly to your A/R days. HFMA’s KPI guidance says best practice is to capture all complete charges within three to five days of the service. Many practices aim for faster, because a claim sent the next day starts the payer’s clock days sooner than one sent the next week.
Set a clear rule for providers to finish and sign notes within a set number of days, and run a daily report of visits with no charge entered. Submit claims every day instead of holding them for a weekly batch. A consistent medical billing process helps practices reduce charge lag and avoid unnecessary submission delays.
4. Send clean claims, and send them electronically
A clean claim is one the payer can process without asking questions. The more of your claims that pay on the first try, the fewer ever reach your aging report. Run every claim through a claim scrubber before it leaves, and fix errors on the spot. Common problems include missing modifiers, wrong diagnosis codes, missing authorization numbers, and incorrect patient details. Many of these common medical billing mistakes can be identified and corrected before claims reach the payer.
Submit electronically whenever you can. As the Medicare timing rules show, paper claims wait much longer before payment can even be issued.
| Why this matters Many practice management guides treat a clean claim rate of 90% or higher as the minimum and 95% or higher as strong. Each claim that fails the first pass can add weeks to your collection time, so clean claims are the biggest single lever you control. |
5. Use electronic remittances and direct deposit
Sign up for electronic remittance advice (ERA) and electronic funds transfer (EFT) with every payer that offers them. Payments arrive faster than by mail, and your billing system can post them automatically instead of someone typing them in. Automatic posting also shows denials and underpayments right away, so you can start working them the same day.
6. Follow up on unpaid claims on a schedule
The most common reason claims sit in your A/R is that nobody checked on them. Do not wait for the remittance to tell you something went wrong. Learn how long each of your main payers normally takes to pay, and check any claim that goes past that window. Most clearinghouses and payer portals let you check claim status electronically, so this does not need a phone call for every claim.
Build a weekly routine. Run a report of claims with no payment or response after your set number of days, assign each one to a person, and record the result. A claim that was never received should be resubmitted to the payer. For pending claims, follow up with the payer to obtain a status update. If a claim has been denied, move it into your denial management process. Understanding why medical claims get denied can help billing teams identify recurring issues and prevent similar claims from aging.
7. Work denials in days, not months
Denied claims are the main reason A/R ages past 60 days. Read the denial codes, decide whether to correct and resubmit or to appeal, and act within a few days of receiving the remittance. Know the appeal deadline for each payer, because a missed deadline turns a recoverable claim into a write-off. Original Medicare, for example, allows 120 days from receipt of the initial determination for the first level of appeal.
Do not only fix the individual claim. Group your denials by reason, payer, and provider each week, and find the cause. These findings can also guide your efforts to reduce claim denials in medical billing and prevent avoidable rework. If the same denial keeps coming back, the fix belongs at the front desk, in the clinical note, or in your coding process.
8. Collect the patient’s share at or before the visit
Patient balances are one of the slowest parts of A/R, and they keep growing. Medical Economics reports that patient responsibility commonly reaches 15% to 20% of practice revenue, with a peak early in the year when deductibles reset. KFF reported an average single-coverage deductible of $1,886 in 2025, and Physicians Practice noted that 34% of covered workers are in plans with a deductible of $2,000 or more.
Once the patient leaves, collecting gets slower and more expensive. The better approach is to collect before they go. Give each patient an estimate of what they will owe, ask for the copay and any known balance at check-in, and keep a card on file with the patient’s permission. Offer a simple payment plan for larger balances and an easy way to pay online or by text. When you must bill the patient later, send the statement soon after the insurance payment posts and follow up on a regular schedule. Before sending a statement, staff should know how to read patient responsibility codes on an EOB to confirm the amount the payer assigned to the patient.
| Note Do not routinely waive copays or deductibles to make collecting easier. Doing so can violate payer contracts and federal or state rules. If a patient cannot pay, use a documented financial assistance or payment plan policy instead. |
9. Bill secondary insurance and fix underpayments quickly
When a patient has a second plan, the clock for that balance starts only after the primary pays. Send secondary claims as soon as the primary payment posts, or confirm that the claim crosses over automatically. Also compare payments with your contracted rates. Payment posting, underpayment identification, and secondary billing are important RCM services that help practices recover outstanding revenue. An underpaid claim that nobody notices sits in A/R forever or gets written off by mistake.
10. Review your numbers on a regular schedule
Look at days in A/R, your aging buckets, and your denial rate every month. Look at your oldest and largest claims every week. Share the results with the front desk, clinical staff, and billing team together, because each group controls part of the result. A short monthly meeting that reviews the same few numbers will do more for your A/R than a large one-time cleanup.
A 30-60-90 Day Plan to Lower A/R Days
If you are not sure where to begin, this plan gives you a simple order of work.
Days 1 to 30: Find the problem
Calculate your current A/R days and your aging buckets. Pull your denial report and sort it by reason and payer. Measure your charge lag and your clean claim rate. Identify your top three payers by A/R balance and the top three denial reasons. Start working every claim over 90 days, beginning with the largest balances.
Days 31 to 60: Fix the front end
Tighten eligibility checks, authorization tracking, and charge entry. Turn on or tighten your claim scrubber rules based on the denial reasons you found. Move to daily claim submission. Start collecting estimated patient balances at check-in and set up an easy way for patients to pay.
Days 61 to 90: Build the routine
Set a weekly follow-up routine with named owners. Set a denial turnaround target, such as working every denial within a few days. Start a monthly review meeting with the same short dashboard each time. By now your newer claims should be moving faster, and your aging report should show the older buckets shrinking.
| Note Expect your A/R days to improve gradually. Old balances take time to clear, and new clean claims take a few weeks to show up in the number. Watch the trend, not a single month. |
How to Work an Aging Report
A clear order of work keeps your team from chasing the wrong claims. Use the same steps each week.
- Sort the report by age and balance, so the oldest and largest claims are at the top.
- Separate insurance balances from patient balances, since they need different follow-up.
- For each insurance claim, check the status. Decide whether it needs a resubmission, a correction, an appeal, or a response to a payer request.
- Check the filing and appeal deadline for every claim over 60 days.
- Record what you did and the next follow-up date in the claim notes, so the next person does not start from zero.
- Send patient balances to statements, calls, or text reminders based on your policy.
- Decide on write-offs using a written policy, and do not write off a balance just to improve the number.
| Note A very low A/R days number is not always good news. It can also mean charges are entered late, claims are written off too quickly, or services are going unbilled. Use A/R days together with your net collection rate and your denial rate. |
Other Numbers That Move With A/R Days
A/R days is the result. These measures show you the causes, so track them alongside it. The targets below are commonly used goals from HFMA and other practice management sources. Use them as a starting point and adjust for your specialty.
| Measure | What it shows | Commonly used target |
| Days in A/R | How fast you collect overall | 30 to 40 days (HFMA) |
| A/R over 90 days | How much money is at risk of going uncollected | Under 10% of total A/R (HFMA) |
| Self-pay A/R over 90 days | How well patient balances are collected | Under 30% (HFMA) |
| Charge lag | Time from visit to charge entry | Within 3 to 5 days at most (HFMA) |
| Clean claim rate | How many claims are accepted first time | 90% or higher, with 95% as strong |
| Initial denial rate | How often claims are refused first time | 5% to 10% typical, under 5% better (AAFP) |
| Net collection rate | How much of what you can collect, you do collect | Track the monthly trend against your own history |
Common Mistakes That Keep A/R Days High
- Holding claims for weekly or monthly batches. Every day a claim waits is a day added to your A/R. Submit daily.
- Waiting for the remittance before checking. If a claim was never received, you will not know until weeks later. Check status on a schedule.
- Chasing only the biggest payers. A pile of small unpaid balances adds up. Set a routine that covers every payer.
- Treating denials as billing-only problems. Many start at registration or in the note. Share denial reports with the whole team.
- Ignoring small patient balances. They are easy to skip, but together they can become a large bad debt number.
- Cleaning up once and stopping. A one-time cleanup lowers the number for a few months. A weekly routine keeps it down.
When to Get Help With Accounts Receivable
Many practices manage A/R in-house until the workload grows past what the team can handle. Signs it may be time for more support include A/R days that keep rising for several months, a growing share of A/R over 90 days, denials that sit unworked, and staff who spend more time chasing payments than helping patients.
A medical billing partner can review your aging and denial reports, set up a steady follow-up routine, and keep up with payer rules. If you are considering this, ask how they report A/R and denial data, how often they follow up on unpaid claims, how they handle appeals, and how they will help your front desk prevent repeat problems.
Frequently Asked Questions
What does A/R days mean in medical billing?
A/R days, or days in accounts receivable, is the average number of days it takes your practice to collect payment for services you have billed. You find it by dividing your total accounts receivable by your average daily charges.
What is a good A/R days number?
HFMA’s published range is 30 to 40 days. The right number for your practice depends on your specialty, payer mix, and claim complexity, so compare your results to your own past performance as well.
How do you reduce A/R days quickly?
Start with the largest and oldest claims on your aging report, then fix the front-end causes: eligibility checks, authorizations, charge lag, and claim scrubbing. Moving from batch submission to daily submission and following up on unpaid claims every week also helps quickly.
How long does it take to improve A/R days?
It depends on how large and how old your current balances are. New claims that go out clean start paying faster within a few weeks. Clearing old balances takes longer. Most practices see steady improvement over a few months when they keep up a weekly routine.
Can A/R days be too low?
Yes. A very low number can hide problems such as late charge entry, quick write-offs, or unbilled services. Check it alongside your net collection rate and denial rate.
How often should I calculate A/R days?
Monthly at a minimum, using the same method each time. Review the aging report and your oldest claims every week.
What is the difference between A/R days and the aging report?
A/R days gives you one average number for your whole practice. The aging report shows how much money is sitting in each age bucket. You need both. A decent average can still hide a growing pile of claims over 90 days.
Final Thoughts
Reducing A/R days is not about working harder on old claims. It is about stopping claims from getting old in the first place. Verify coverage early, send clean claims fast, follow up on a schedule, work denials quickly, and collect the patient’s share up front. Then review the same few numbers every month so you can see what is working.
Practices that follow this routine usually see their aging report get lighter over time, their cash flow become more predictable, and their staff spend less time on rework.
| Need help bringing your A/R days down? If unpaid claims are piling up and your team is stretched thin, Proactive Healthcare Services (PHCS) can review your aging and denial reports, find where the delays start, and support your medical billing so you get paid faster. Contact PHCS to discuss your practice. |
