AR follow-up should become more intensive as claims age, but there isn’t one universal follow-up schedule for every practice or payer. A practical approach is to review AR aging regularly, monitor newer claims for exceptions, actively work unresolved claims as they enter older aging buckets, and give immediate attention to claims approaching payer-specific timely filing or appeal deadlines. MGMA tracks AR using 0-30, 31-60, 61-90, 91-120, and 120+ day buckets, while HFMA publishes AR performance benchmarks practices can use alongside their own payer mix and specialty data.
What AR Benchmarks Mean for Follow-Up Frequency
Follow-up cadence isn’t an arbitrary schedule. It’s built around a specific target: keeping the practice’s overall accounts receivable inside a defined, healthy range. HFMA’s published KPI guidance identifies 30 to 40 days in AR as a target range and recommends keeping AR over 90 days below 10% of total receivables, with self-pay AR over 90 days kept below 30%. MGMA maintains its own benchmarking data, including an AR aging dashboard that breaks receivables into standard buckets, 0-30, 31-60, 61-90, 91-120, and over 120 days, to help practices analyze their own aging distribution and compare performance with relevant MGMA benchmarks.
Those targets are the reason follow-up frequency isn’t flat across a claim’s lifecycle. A claim sitting at 15 days old doesn’t generally carry the same urgency as one at 75 days. Older AR contributes more heavily to aging metrics and may have fewer remaining options as payer filing and appeal deadlines approach.
Recommended Cadence by Aging Bucket
Exact timing varies by practice, payer, and claim type. The following is a practical framework for structuring follow-up rather than a universal industry standard:
0-30 days: Claims in this range may still be in the payer’s normal claim processing window, depending on the claim type and the payer. The aging report is viewable regularly, and for rejected claims, unusual status changes, high-dollar claims, and others, action is taken earlier.
31-60 days: This is the right time to start more vigorous follow-up of unclosed claims. If there is a claim, check if the claim was received by the payer and the claim status, and if there is a rejection/denial/pend reason, check for it before the balance moves to an older bucket. Depending on the turnaround times of payers and the availability of staff, there is an option for following up within one to two weeks after entry into this bucket.
61-90 days: Claims at this stage are considered materially older AR and should be given priority follow-up since they may have fewer days to address payer issues prior to filing or appeal deadlines.
90+ days: Claims this old generally warrant high-priority attention, particularly when a payer deadline, denial, appeal, or documentation issue is unresolved. MGMA’s benchmarking material specifically tracks 120+ day AR as an important indicator, and better-performing practices tend to carry less AR in that oldest bucket.
Underneath this age-based structure, claims approaching a payer’s specific timely filing deadline need same-day attention regardless of where they otherwise sit in the aging schedule. Missing a payer’s timely filing deadline can make a claim ineligible for payment or significantly limit the options for recovering the balance, depending on the payer’s rules and applicable exceptions.
Age Isn’t the Only Variable Worth Weighing
Strict aging-based cadence is a reasonable default, but it isn’t the whole picture. A $50 claim sitting at 40 days and a $4,000 claim sitting at 40 days don’t carry the same urgency, even though they’re the same age, and a practice may reasonably weight follow-up priority by dollar value as well as age for exactly that reason. Denials and underpayments also call for different handling even at the same age. A denied claim generally requires the underlying reason to be addressed and may require an appeal. An underpayment, where the amount paid is less than what the practice expected under the applicable contract or reimbursement terms, requires a separate payment review comparing the payer’s reimbursement with the applicable contract, fee schedule, or expected allowed amount.
Daily, Weekly, and Monthly Review Serve Different Purposes
Follow-up cadence and reporting cadence aren’t quite the same thing, and conflating them is a common source of confusion. MGMA recommends tracking revenue-cycle KPIs at least monthly for administrative leaders, with more frequent review for billing staff working claims day to day. A practice can use that more frequent, claim-level review to identify balances that need action before they move into older aging buckets, while reserving the monthly cadence for assessing whether overall days in AR and the percentage of AR over 90 days are staying inside target range. A practice can have strong claim-level follow-up day to day and still miss a slow drift in its overall AR metrics if nobody’s reviewing the aggregate numbers on a regular schedule too.
A Quick Reference Checklist
| Aging Bucket | Suggested Follow-Up Approach |
| 0-30 days | Review regularly; monitor for rejections, unusual status, or other exceptions |
| 31-60 days | Increase active follow-up on unresolved claims |
| 61-90 days | Prioritize unresolved claims and investigate outstanding payer issues |
| 90+ days | High-priority follow-up, especially where deadlines or unresolved denials are involved |
| Approaching timely filing deadline | Same-day action regardless of age bucket |
| Overall AR performance | Review at least monthly at the leadership level, more frequently for billing staff |
Conclusion
Consistent AR follow-up depends on a structured cadence being applied every week, not just when someone has spare time between other tasks. Rapid RCM Solutions supports this through its AR and denial management services, helping practices work aging claims on a disciplined schedule and resolve denials and underpayments before they become more difficult or time-sensitive to recover.
FAQs
What’s a healthy Days in AR benchmark for a medical practice?
HFMA’s published guidance identifies 30 to 40 days in AR as a target range. MGMA separately provides AR aging and days-in-AR benchmarks that allow practices to compare performance by relevant practice characteristics.
Should every claim be followed up on the same schedule?
No. A practice can prioritize follow-up using multiple factors, including claim age, dollar value, payer, denial status, filing deadlines, and the likelihood or cost of recovery.
Is reviewing the AR aging report weekly enough?
A weekly review can be useful for operational follow-up, but the appropriate frequency depends on the practice. MGMA recommends tracking revenue-cycle KPIs at least monthly for administrative leaders and more frequently for billing staff. Claims approaching payer deadlines may require same-day action regardless of the normal reporting schedule.
Why does follow-up urgency increase so much after 90 days?
Older claims deserve increasing attention because they contribute to aged AR and may have fewer days remaining to resolve payer issues before applicable filing, reconsideration, or appeal deadlines. The exact deadline depends on the payer, contract, and claim circumstances.
