Old accounts receivable (AR) is the fastest way to choke your cash flow. Once claims age past 90–180 days, the chances of recovery drop, payer reps become harder to deal with, and every follow-up becomes more expensive.

If you don’t clean aged AR strategically, you lose money.
Here’s a concise, no-nonsense workflow to recover old AR efficiently.

1. Segment the AR Before You Touch Anything

You can’t fix AR if you don’t classify it properly.

Break the aging into:

• 0–90 days (active, normal)

• 90–120 days (at-risk)

• 120–180 days (critical)

• 180+ days (low recovery probability)

Then segment by:

• Payer

• CPT/Service type

• Denial reason

• Provider

• Location (if multi-site)

Smart segmentation tells you exactly where the leakage is happening.

2. Prioritize High-Value & High-Probability Claims

You don’t chase everything at once.

Start with:

• Clean claims with minor issues

• High-dollar visits

• Payable codes that historically pay well

• Medicare/Commercial (faster turnaround)

Avoid wasting time on:

• Claims missing medical records

• Claims requiring full clinical review

• Services that never had authorization

• Payers known to deny 180+ day corrections

Target the money you can still win.

3. Identify the Root Cause (Don’t Just Resubmit)

Most clinics simply “resubmit,” which is why AR keeps aging.

Check the real reason:

• Was the claim never submitted?

• Sent to wrong payer ID?

• COB not updated?

• Provider NPI/TAX mismatch?

• Authorization missing or expired?

• Notes not signed?

• Demographic errors?

• Clearinghouse rejection never fixed?

Fix the root cause before resubmitting.

4. Call the Payer With a Scripted Approach

At 90–180 days, payers won’t help unless you’re structured.

Your team must confirm:

✔ Date claim was received
✔ Denial reason from payer system
✔ Corrected claim requirements
✔ Mailing address or portal submission rules
✔ Timely filing override options
✔ Notes or medical records needed
✔ Appeal timeframe
✔ Reference number for every call

A call without a reference number = wasted time.

5. Fix and Resubmit the Claim Correctly

Based on payer rules, choose the right approach:

• Corrected Claim

• Reconsideration

• Appeal

• Secondary Claim

• COB Update

• Medical Records Submission

Attach all required documents:

• Signed notes

• Corrected CPT codes

• Authorization proof

• EOB/ERA

• Claim history

• Provider credentials (if needed)

Make sure the claim matches exact payer requirements — each payer is different.

6. Track Every Follow-Up in a Live AR Log

This is where clinics fail.

Your AR log must include:

• Claim date

• Payer

• DOS

• Billed amount

• Status

• Last call date

• Rep name

• Reference number

• Next follow-up date

• Expected turnaround

Nothing gets lost.
Nothing gets missed.

7. Escalate Claims That Hit 150–180 Days

When claims approach 150+ days, frontline reps won’t help.
Escalate to:

• Provider Relations

• Payer Supervisor

• Payer Resolution Team

• Dedicated escalation portals

If documentation is strong, file an appeal even if timelines are tight.

This is where clinics recover money that most billers write off.

8. Clean the Workflow So It Doesn’t Happen Again

AR cleanup is useless if the same errors repeat.

Fix the upstream issues:

• Eligibility not verified

• Wrong codes or modifiers

• Missing signatures

• Incorrect payer mapping

• Schedulers booking without auth

• Notes not locked on time

• Claims submitted without QA

Build a pre-billing checklist to prevent 90–180 day AR from happening again.

Bottom Line

Old AR isn’t just a billing problem — it’s a cash-flow threat.
A structured AR cleanup process can recover 20–40% of revenue stuck in aging buckets and restore financial stability.

If your clinic needs help recovering aged claims or wants us to build a structured AR workflow, we can support you end-to-end — from cleanup to prevention.