Top 7 Questions to Improve Healthcare Accounts Receivable Performance

Most healthcare providers in the US are struggling with a growing volume of accounts receivable (AR). The latest industry data from a recent survey by the National Library of Medicine (NLM) in 2024 shows that the medical debt was about $194 billion. It is a significant amount, which can even break the banks of many medical practices, especially small and mid-scale ones.

If you review your practice finances, you may also discover that your medical accounts receivable is growing. If the outstanding amount is small, it may not seem concerning at first; however, over time, it can become a lump sum amount. As we know, your financial stability also depends on timely and accurate collections. Outstanding accounts can limit your ability to invest in staff, equipment, and improvements in patient care. In fact, research shows that many physicians in the US struggle with inefficient accounts receivable (AR) systems.

Valuable Questions to Optimize Your Healthcare Accounts Receivable Process

As a healthcare provider—whether you run a small clinic, are a specialist in a larger group, or lead a multi-physician practice—you must ask the right questions to understand where your system fails and how to fix it. Below are seven practical questions to help identify and resolve issues in your healthcare accounts receivable process. Each question invites insight, prompts action, and aims to restore financial stability for your practice.

Question 1: What does the aging report really say about the organization’s AR?

Accounts receivable in healthcare is usually separated by age. Hence, if you are managing receivables, you must accurately track metric. It will give the exact number, and hence, providers do not need to depend on their guesses. Here, one key metric is “days in AR“. It is determined by calculating the average number of days to collect payment. Here, the AR management team must try harder to keep the age of pending accounts under 40 days. If it increases and goes out of control, the practice will be exposed to a serious cash-flow risk.

Question 2: How are claims being prioritized in the accounts receivable work queues?

Not all claims require equal attention; prioritize those with a higher likelihood of collection. Hence, smart billing teams and accounts receivable management services for physicians organize their work queues based on claim age, payer rules, and balance size. Here are the different segments to prioritize your accounts receivable:

• Aging
• Balance Amount
• Payer/Customer Type
• Denial Status/Reason
• Expected Recovery/Probability of Payment

Prioritizing aged claims helps recover cash faster and prevents revenue from becoming uncollectible. Here, collecting claims less than 30 days old is significantly easier to collect in comparison to older claims.

Question 3: How does the organization’s “Days in AR” stack up against industry standards?

“Days in accounts receivable” will help practices estimate how long it typically takes for a claim to be paid. For most US healthcare practices, anything under 40 days is considered solid. If the outstanding accounts are hitting 50 or 60 days, it asks for dedicated attention. This number reveals whether your process is efficient, from the beginning, i.e., charge capture to final AR follow-up. If it’s creeping higher each month, it’s time to find out why before the cash flow tightens any further.

Question 4: How frequently does the medical billing team dig into denial trends?

Every medical billing department has that corner of the system where tricky claims end up. The revenue cycle management services for physicians must analyze the denied claims to find if there are any common patterns of errors. From that analysis, they may encounter the following scenarios:

1. Claim denied for reasons that don’t make sense
2. Missing one document and nobody can find it
3. Waiting on a payer who’s impossible to reach
4. Confusing healthcare regulations that results in erroneous claims

If practices can devise an effective plan for how outstanding accounts are handled, they’ll continue to sit unresolved. Good practices don’t leave it to chance. They set timelines for when a claim gets escalated and who takes it next. It streamlines the overall collection process.

Read More:

Turning Aged Medical Accounts Receivable into Cash Flow: The Smart Recovery Strategy

Question 5: What tools does the team actually use to track AR and performance?

Let’s be honest, a lot of offices are still trying to manage accounts receivable out of Excel sheets and sticky notes. It works for a while, but it’s not sustainable. The best-run practices have a dashboard in their electronic health record (EHR) system that shows what’s happening in real time. These tools efficiently reflect all present metrics, such as:

• Number of claims submitted
• Balances by payer
• Days since last follow-up

For providers, efficient tools don’t only make reports. In fact, they tell the full story of the practice’s financial standing. They reveal workload distribution, payer delays, and potential bottlenecks.” These details will offer better insights into how to minimize accounts receivable.

Question 6: How fast does the medical billing team follow up after a denial or a short payment?

Payment doesn’t reach the provider’s end automatically; here, timely AR follow-up plays a crucial role. Providers must not leave denied claims, as they increase their AR bucket. Moreover, the longer a denial sits, the chances of collection decrease accordingly. The payer moves on, documentation gets misplaced, etc. This way, suddenly, the billing staff realize it’s too late to appeal. Hence, professional medical accounts receivable specialists don’t wait. Indeed, effective teams act within a few days to a week. Here, that kind of urgency pays off, literally. Fast and continuous follow-up keeps cash flowing. In addition to that, these efforts send a clear message to payers that this practice doesn’t leave their money as bad debts.

Question 7: Should the organization consider outsourcing accounts receivable follow-up?

A dedicated healthcare accounts receivable services outsourcing company only focuses on collections. They have a team of experts who effectively negotiate with payers and patients to collect the outstanding accounts as soon as possible. It is because these third-party AR experts know all-inclusive payer rules. Moreover, they know how to escalate to secure the accounts faster. Now, most providers have a common misconception that outsourcing accounts receivable in healthcare will take administrative control out of their hands. However, the actual picture is just the opposite. A reliable outside partner can help you finally get the numbers where they need to be without losing any control.

How SunKnowledge Stands Out as a Reputable Healthcare Accounts Receivable Outsourcing Company

SunKnowledge Inc. has over 17 years of proven track record of securing payment for healthcare providers in the US. We offer full-cycle handling of accounts receivable. This includes claim submission, denial management, and patient collections. We describe our service as “a one-stop shop” for your entire AR management, with follow-through and final billing. We offer the following services to our clients:

We offer end-to-end accounts receivable management services with top-notch medical billing and RCM.

We rely on data and analytics-driven performance to identify the inefficiencies present and take corrective measures.

Our performance metrics show a minimum of 97% growth in collection. Moreover, we ensure about a 30% reduction in AR within one month.

We offer the most affordable pricing. We don’t ask for any payment up front. Providers pay only a small portion after collections are received.

We do not write off for even small amounts nor do any adjustments without our urgent care client’s consent.

Hence, if you are searching for a way out to keep your finances strong, it’s time to partner with us. Initially, you only need to contact us and discuss your AR related issues. You will pay us after your outstanding accounts start to reach your collections bucket.