Denials and A/R · 2026-02-12 · 4 min
Strategies to Reduce Days in A/R
Why days in A/R moves, which balances distort it, and the queue rules that change it without a magic number.
Define the measure before you chase it
Days in A/R is outstanding receivables divided by an average day's charges. It rises when balances sit, and it also rises when credits sit, when unbilled charges are excluded or included inconsistently, and when a fee schedule is far above allowed amounts. Two practices with the same habits can post different days if their charge masters differ.
Write down the exclusions. Decide whether patient balances, payment plans, and credit balances count. Then a movement means something.
Sort the inventory
An aging report is not a work queue. Split unbilled encounters, rejections, claims in process, denials, and patient responsibility. Age is the second sort. A claim that is twenty days old and still rejected can be closer to a filing limit than a claim that is ninety days old and already decided.
Untouched inventory is its own number. A low days-in-A/R average can hide a tail nobody has opened. Count the tail.
Fix posting before you add callers
Unposted remits make days in A/R look worse than the payer's behavior. So do contractual adjustments left on the claim as if they were unpaid. Reconcile deposits to posted batches before you hire another person to call on balances that were paid last Tuesday.
Zero-pay remits matter. They are often denials. Leaving them unposted keeps the claim in the open bucket and may let a statement go out.
There is no published day-count to hit
We will not offer a universal target. A surgical practice and a pediatric practice should not share one. Use your own baseline, look at the drivers, and change the queue that is actually old. If most of the age is past the appeal window, the honest move is a write-off proposal plus an upstream fix, not more calls.
The calculator on our assessment page can illustrate how days and a collection rate interact with billed charges. It is an educational formula. It is not your A/R balance and not a recovery forecast.
Work the tail, then the average
Sort open balances into unbilled, rejected, in process, denied, and patient responsibility before you look at the average. Assign the oldest item in each bucket a next action and a date. An average that falls because credits were netted, or because old balances were written off without a policy, is not an improvement in follow-up.
Review the sort monthly against the same exclusions you wrote down. If the tail is mostly past the filing or appeal window, the honest recommendation is a write-off proposal plus a change at charge entry. More phone calls will not reopen a closed deadline.