Accounts Receivable Management
US Medical Billing works your accounts receivable the way it should be worked: aged claims are triaged by bucket and by payer, unpaid and underpaid claims are followed up before timely-filing windows close, small balances are handled with a deliberate strategy, and write-offs happen by policy rather than by default.
- Aged A/R worked by bucket and payer
- Follow-up on unpaid and underpaid claims
- Write-offs governed by policy, not default
- Secondary and patient balances pursued
What accounts receivable management does
Accounts receivable is everything a payer or patient owes you that has not yet been collected. A/R management is the disciplined follow-up on that outstanding balance — tracking each claim after submission, chasing what has stalled, questioning what was underpaid, and moving every dollar toward resolution before it ages out of reach.
Without active follow-up, A/R drifts. Claims sit unpaid past timely-filing deadlines, partial payments go unquestioned, and small balances accumulate until they are quietly written off. Days in A/R climbs, and revenue you already earned never arrives.
We work your receivables as a standing operation: aging is reviewed by bucket and by payer, follow-up is prioritized by value and by deadline, and every adjustment is categorized so your books reflect what was genuinely contractual versus what was truly uncollectible.
Who it's for
A/R management fits practices where earned revenue is stalling in the aging report rather than landing in the bank.
Practices with rising days in A/R
When the average time to collect keeps climbing, claims are sitting unworked somewhere in the cycle. Structured follow-up is what brings that number back down.
Groups with a growing aged bucket
Balances that slip past 90 and 120 days are the hardest to collect and the closest to timely-filing limits. They need deliberate attention before they become write-offs.
Teams without follow-up capacity
Submitting claims is only half the job; someone has to work what does not pay. When billing staff are stretched, follow-up is the first thing that slips.
What's included
A/R management is the follow-up layer of the revenue cycle. These are the core activities that keep outstanding balances moving toward resolution.
Aging review by bucket
The aging report is segmented by 0-30, 31-60, 61-90, 91-120, and 120-plus day buckets, and by payer, so effort goes where revenue is most at risk.
Payer follow-up on unpaid claims
Stalled claims are chased through status inquiries (276/277), payer portals, and calls, then corrected and resubmitted where needed.
Underpayment recovery
Payments are checked against the allowed and contracted amount, and shortfalls are reworked or appealed rather than accepted as paid in full.
Small-balance strategy
Low-dollar balances are handled with defined thresholds and batching so they are resolved deliberately, not written off by default.
Write-off governance
Adjustments are applied against a policy you approve and categorized as contractual, administrative, or bad debt — never as a silent catch-all.
Secondary and tertiary billing
Once the primary adjudicates, remaining balances are coordinated and filed to secondary and tertiary payers so coverage is fully exhausted.
Timely-filing protection
Follow-up is sequenced against each payer's filing window so claims are worked before the deadline that would forfeit the right to be paid.
Denial coordination
Denials that surface during follow-up are routed into the denial workflow for correction and appeal, keeping A/R and denials on the same track.
How A/R gets worked
Follow an outstanding balance from the aging report to resolution. Each stage decides whether earned revenue is collected or lost.
Aging snapshot
The current aging report is pulled and segmented by day bucket and by payer, giving a clear picture of what is outstanding and how old it is.
Inputs and outputs
A/R follow-up runs on the records your systems already produce and returns a worked, categorized aging report.
What you provide
- Aging / accounts receivable report from your practice management system
- Remittance advice (835/ERA) and EOBs showing what each payer actually paid
- Payer contracts or fee schedules to check expected allowed amounts
- Access to your PM system, payer portals, and clearinghouse for status and resubmission
What you get back
- A worked aging report with each account moved toward resolution
- Follow-up notes and the next action logged against each claim
- Secondary and tertiary claims filed and true patient balances routed to statements
- Categorized adjustments that separate contractual write-offs from recoverable balances
Responsibilities and boundaries
A/R management owns the follow-up on outstanding balances. Some decisions are made jointly, and some stay entirely with your practice.
We handle
- Working the aging report and following up on outstanding claims by bucket and payer
- Identifying underpayments and routing them for rework or appeal
- Filing secondary and tertiary claims and reconciling coordination of benefits
- Applying and categorizing adjustments against your approved write-off policy
Shared
- Write-off thresholds and small-balance rules — you set the policy, we apply it consistently
- Denials that surface during follow-up — worked together with denial management
- Patient balances that need statements, payment plans, or a collections decision
You keep
- Clinical documentation and the coding of the underlying encounter
- Final authority over write-offs, discounts, and any balance sent to collections
- Payer contract terms and fee-schedule negotiation
Common process failures
Most lost A/R is not written off on purpose — it slips through predictable gaps. These are the failure modes follow-up is built to prevent.
Claims aging past timely filing
With no systematic follow-up, a claim can sit in an aging bucket until the payer's filing window closes and it is denied as untimely — often with no appeal right. Deadline-driven triage works these claims before the window shuts.
Underpayments accepted as paid
A partial payment posts, the claim looks closed, and the balance is adjusted off without anyone checking paid against the contracted allowed amount. Variance checks against the fee schedule catch shortfalls so they can be reworked.
Small balances written off by default
Low-dollar balances feel individually not worth chasing, but they drain real revenue in aggregate. A defined small-balance strategy — thresholds, batching, and patient statements — resolves them deliberately instead of by habit.
Secondary balances never billed
After the primary pays, the remaining balance is left unbilled because coordination of benefits was never set up or an automatic crossover was assumed but never happened. Checking each ERA for remaining responsibility ensures the secondary claim actually goes out.
Reporting and visibility
You see the state of your receivables and the work being done against them — without a fabricated benchmark in sight.
Aging by bucket and payer
The distribution of outstanding balances across day buckets and payers, so you can see where revenue is concentrated and how it is trending.
Follow-up activity and status
What was worked, what action was taken, and what each account is waiting on, so follow-up is visible rather than assumed.
Adjustments and write-offs by category
Contractual, administrative, and bad-debt adjustments reported separately, so nothing recoverable is hidden inside a single write-off line.
What to expect
How we approach A/R follow-up — these describe the service, not guaranteed outcomes.
Follow-up on a schedule, not in a crisis
Aging is worked as a routine operation, so balances are pursued while they are still collectible rather than after they have aged out.
Deadlines drive the queue
Timely-filing windows and payer-response clocks decide what gets worked first, so nothing is forfeited to a missed deadline.
Underpayments are questioned
A payment is compared to what the contract says it should be, and shortfalls are pursued instead of quietly accepted.
Write-offs by policy, visible on the books
Nothing is adjusted off by default; write-offs follow the policy you approve and are categorized so your reporting stays honest.
Related & connected
A/R management sits between the work that creates balances and the tools that measure them. These are the closest connections.
Related services
Calculators & tools
- Days in A/R calculatorEstimate the average time it takes to collect, the headline measure of A/R health.
- Net collection rate calculatorSee how much of the collectible revenue you actually captured after contractual adjustments.
- Gross collection rate calculatorCompare payments to total charges for a top-line view of collection performance.
From the Knowledge Base
- Underpayments and overpaymentsHow to spot when a payer paid the wrong amount, and what to do about it.
- Revenue cycle KPIsThe metrics that tell you whether your A/R is healthy, including days in A/R and collection rates.
- Secondary billingHow coordination of benefits works and how to bill the secondary payer correctly.
Frequently asked questions
What is days in A/R, and why does it matter?
Days in A/R measures the average time it takes to collect what you have billed — outstanding receivables divided by average daily charges. It is the single clearest signal of A/R health: when it climbs, claims are sitting unworked somewhere in the cycle. Follow-up that resolves balances by bucket is what brings it back down. You can estimate your own with the days in A/R calculator.
Do you work old A/R, or only current claims?
We work aged buckets, not just fresh claims — the 61-90, 91-120, and 120-plus day balances are usually where the recoverable revenue is hiding. The honest constraint is timely filing: every payer has a deadline after which a claim can no longer be submitted or appealed, so the oldest balances are triaged first, and some may already be past the point of recovery.
How do you decide what to write off?
Nothing is written off by default. Write-offs follow a policy you approve, with thresholds for small balances and clear categories — contractual adjustments (the expected difference between billed and allowed), administrative write-offs (such as a missed filing deadline), and bad debt (uncollectible patient responsibility). Each is reported separately so nothing recoverable is buried in a single adjustment line.
How does A/R management relate to denial management?
They are complementary. A/R follow-up is where denials and underpayments are discovered as claims are worked through the aging report; denial management is where those claims are corrected, appealed, and their root cause addressed so they stop recurring. Run together, follow-up feeds the denial workflow and the denial workflow keeps the aging report from refilling with the same problems.
Explore more
Keep exploring — by specialty, by topic, or with practical tools.
Ready to improve your revenue cycle?
Explore our services and knowledge base to see how we can help.