Accounts Receivable (AR) is the heartbeat of your revenue cycle. Yet many clinics let thousands of dollars sit untouched in aging buckets — not because payers are slow, but because their internal workflows are broken.

If your AR is climbing past 30, 60, or 90 days, chances are your billing team isn’t the issue — it’s your operational processes.

Here are the real reasons claims get stuck in AR and how to fix them immediately.

1. No Structured Follow-Up Schedule

Many clinics don’t have a consistent follow-up cadence. Claims end up sitting untouched for weeks.

Impact:

• Increased denials

• Delayed payments

• Missed resubmission windows

Fix:
Follow this basic cadence:

• Day 0 → Submission

• Day 15 → First follow-up

• Day 30 → Second follow-up

• Day 45 → Correction/appeal

• Day 60+ → Escalate / Provider rep call

2. No Aging Bucket Ownership

Most practices don’t assign responsibility for:

• 0–30

• 31–60

• 61–90

• 90+

As a result, AR piles up with no owner.

Fix:
Assign each bucket to a dedicated team member.
Measure performance weekly.

3. Missing Documentation From Providers

If notes aren’t completed or signed, billing stalls — and AR starts climbing.

Common issues:

• Unsigned notes

• Wrong CPT codes

• Missing minutes

• Missing diagnoses

Fix:
Set a provider rule: Notes signed within 24 hours or visit won’t be billed.

4. Payers Request Info — But Nobody Checks the Portal

Insurance portals often flag:

• Medical records requests

• Coordination of benefits

• Plan changes

• Reprocessing requirements

If nobody checks daily, claims sit untouched.

Fix:
Daily portal checks on UHC, BCBS, Aetna, Cigna, Medicare, Medicaid MCOs.

5. No Tracking for Denials & Trends

Many clinics handle denials “case-by-case,” without spotting patterns.

The result:
The same denial repeats for months.

Fix:
Create a denial log tracking:

• Denial reason

• Payer

• Code

• Provider

• Fix applied

This alone cuts AR by 20–30%.

6. Incorrect VOB or Missing Authorization

If VOB is wrong, claims go into AR automatically.

Examples:

• Wrong plan type

• No auth

• Expired auth

• Wrong payer ID

Fix:
Eligibility + auth verified for every single visit.

7. No Clear Escalation Workflow

When a claim hits 60+ days, most clinics do nothing — they “wait for payer updates.”

Wrong.

Fix:
60+ days = escalate:

• Provider rep

• Payer supervisor

• Reprocessing request

• Appeal

Final Takeaway

AR problems don’t start at the payer — they start inside your workflow. When you build a structured follow-up strategy, enforce documentation rules, and monitor trends, AR reduces dramatically and cash flow stabilizes.

If your aging report is out of control, our team can clean it, rebuild your workflow, and improve recovery within weeks.