What the Aging Report Is
AR aging distributes outstanding receivables into time buckets — typically 0–30, 31–60, 61–90, 91–120, and 120+ days — from either date of service or date of billing (pick one; document it). It is the revenue cycle’s inventory report: not how fast money moves (that is days in AR) but where the stuck money sits and how long it has been stuck.
Reading the Shape
Healthy AR is front-loaded: the large majority in 0–60 days (claims in normal processing), a modest 61–90 band (rework and slow payers), and a small tail beyond 90. Commonly cited discipline: keep AR over 90 days under roughly 15–20% of the total, with payer mix adjustments — comp, personal injury, and heavy Medicaid managed care age structurally older.
Shape changes are the signal: a swelling 61–90 band means follow-up is losing the race; a growing 120+ tail means claims are dying unworked; a bulge in one payer’s aging means that payer — or your workflow for it — changed.
Slicing That Makes It Actionable
- By payer: finds the slow and the misbehaving; supports escalation and contracting data
- By financial class: insurance versus patient balances need different workflows entirely
- By status: billed-awaiting-response versus denied-in-work versus untouched — the last category is the indictment
- By balance size: batches small balances into efficient workflows instead of per-claim decisions
Working the Report
The aging report should drive queues, not decorate meetings: every bucket past the normal-processing window maps to an action — status sweeps at 25–30 days, denial work with deadlines docketed, escalation paths for the chronically silent, and documented write-off recommendations for the provably dead. The metric of a worked report is last-touch recency: aged claims with no follow-up notes are the operational confession.
Common Errors
- Printing the report monthly and working it never
- Mixing credits into the aging, netting balances that hide both problems
- Letting service-date versus bill-date definitions drift between reports
- Treating patient balances with insurance-claim workflows and vice versa
Practical Checklist
- One aging basis (service or bill date), documented
- Sliced by payer, class, and status monthly
- Over-90 share tracked against a stated target
- Every aged claim carries a last-touch date and next action
- Credits reported separately, not netted
Frequently Asked Questions
Our over-90 bucket is 35% — where do we start? Triage before effort: classify the bucket by recoverability and deadline status, work the live-deadline claims first, and close the documented-dead with reasons. Then fix the intake side — the follow-up gap that let claims age — or the bucket refills behind the cleanup.
Should aging run on service date or billing date? Service date exposes your internal lag (charges entered late age from day one, honestly); billing date flatters it. Service date is the more truthful discipline — just hold whichever you choose constant.