Key takeaways
- Clean the aging report before working it.
- Work high value claims that are still inside their deadlines first.
- Fix the process that created the old AR so it does not return.
Most practices have some old AR: claims that were never paid, denials nobody appealed, and balances that sat after a staff change or a system switch. Some of it can still be collected. Some cannot. The goal is to sort it quickly, work the collectable part first, and stop new old AR from building up.
Step 1: Get a clean aging report
Run AR aging by payer and by date of service. Before working anything, clean the data. Post any unposted payments and adjustments, and remove duplicates. Otherwise you will spend time chasing claims that are already paid.
Step 2: Sort by what is still possible
- Check each payer's timely filing and appeal limits. Medicare generally allows 12 months from the date of service for the original claim, and many commercial and Medicaid plans allow much less.
- Separate claims never received by the payer from claims that were denied.
- Identify claims where you have proof of timely filing, such as clearinghouse acceptance reports.
- Flag patient balances separately from insurance balances.
Step 3: Prioritize by value and deadline
Work the highest value claims that are still inside their filing or appeal windows first. A claim a few weeks from its appeal deadline deserves attention before a newer claim with time to spare.
Step 4: Find out what happened to each claim
- Check status with the payer portal or by phone.
- If the payer has no record, resubmit with proof of timely filing where available.
- If the claim denied, read the reason and decide whether to correct and resubmit or appeal.
- If it was paid, find and post the payment.
- Record every action and the next follow up date.
Step 5: Decide what to write off
Some claims are past every limit and cannot be recovered. Decide on a clear write off policy, with approval rules, so old balances do not stay on the books and distort reports.
Step 6: Stop it from building again
Old AR is usually a symptom. Look at why the claims aged: missed rejections, unworked denials, late posting, or no regular follow up. Fix the process, then review aging monthly.
Old AR projects work best when they are separate from day to day billing, with their own list, owner, and report, so current claims do not slip while the backlog is worked.
What to report as you go
- Dollars collected from old AR, by payer.
- Claims resolved, corrected, appealed, or written off.
- Main reasons the claims aged, so the fix can be made upstream.
A quick example
After a billing staff change, a practice finds a large group of unpaid claims across several payers. Cleaning the aging report removes payments that were simply never posted. The rest is sorted by deadline and value. Claims still inside their limits are worked first, and the main cause, rejections that nobody checked, is fixed with a daily rejection review.
Where Afiable helps
Afiable can take on old AR as a separate project: cleaning the aging report, prioritizing by value and deadline, and working each claim to resolution with clear reporting. Book a free audit and we will review your aging and show you how much is still collectable.
Questions practices ask
Can claims past timely filing still be paid?
Sometimes, if you can show the claim was submitted on time, such as with clearinghouse acceptance reports. Without proof, most payers will not pay.
How long does an old AR project take?
It depends on the volume, the number of payers, and how many claims are still within their limits. Starting with the highest value claims shows results soonest.
This article is general information for practice owners and managers. Payer policies and regulations change, so confirm current rules with each payer before acting.