Revenue Cycle Management

Home›Resources›Blogs›Reducing Days in Accounts Receivable: Proven Strategies for Faster Payments StafGo Health  |  +1 (212) 655-7679  |  stafgo.com  |  HIPAA-Eligible RCM Services Quick Answer Days in A/R measures how long it takes to collect billed revenue. Most practices target 30 to 40 days, with strong performers below 30. Reductions come from front end accuracy, clean claim submission, systematic denial management and disciplined follow up, not from chasing aged claims alone. What This Guide Covers Why days in A/R is the measure that reveals everything Calculating it correctly, and the measure that matters more Where the days actually accumulate Front end: preventing the delay before it starts Mid cycle: coding and clean claim submission Back end: follow up, denials and appeals The patient responsibility problem Automation and where it genuinely helps The dashboard worth building Frequently asked questions Days in accounts receivable is the single most revealing number in a practice’s financial reporting. It is also the most misread. A practice sees the figure climb from 34 to 47 and responds by pushing the billing team to chase aged claims harder, which addresses the symptom and leaves the cause untouched. The days accumulated somewhere. Usually not in the follow up queue. More often at registration, in a coding decision, or in a denial that was never worked because nobody owned it. Why Days in A/R Is the Measure That Reveals Everything Days in A/R is a downstream indicator. Every upstream failure eventually shows up in it. An eligibility check skipped at the front desk becomes a denial three weeks later, which becomes an appeal, which becomes a balance sitting at 90 days. The number tells you something is wrong. It does not tell you where. That is why the useful work is diagnostic rather than corrective. Practices that reduce days in A/R durably do it by finding where the delay originates. Practices that attack the aged bucket get a temporary improvement and watch the number climb back. 30-40 daysCommon target range for most practicesBelow 30Where strong performers operateUnder 15%Target for A/R aged beyond 90 days Calculating It Correctly, and the Measure That Matters More Days in A/R is total accounts receivable divided by average daily charges, where average daily charges are gross charges over a period divided by the days in that period. Use a rolling 90 or 120 day window rather than a single month, because charge volume varies and a single month will distort the result. The measure that matters more than the headline number Aging distribution tells you more than the average. A practice at 38 days with almost nothing beyond 90 is healthier than one at 32 days carrying a significant aged bucket, because collectability falls sharply after 90 days and again after 120. Track the percentage of A/R over 90 days alongside the headline figure. If the average improves while the aged bucket grows, the improvement is arithmetic rather than real. Where the Days Actually Accumulate Stage What adds days Typical cost Registration Incomplete demographics, unverified eligibility, missing subscriber detail Denial and rework, adding 21 to 45 days Authorisation Service performed before authorisation obtained or documented Denial with limited appeal prospects Coding Incorrect code, missing or invalid modifier, insufficient documentation Denial or downcoding, adding 30 or more days Submission Claims batched rather than submitted daily, clearinghouse rejections unworked 2 to 10 days lost before the claim is even received Follow up No systematic work queue, claims touched only when someone has time Claims age past timely filing and become uncollectable Denials Denials posted and not worked, or worked without root cause analysis The same denial recurs indefinitely Patient balances No collection at time of service, no structured statement cycle Longest aging and lowest collection rate in the ledger Read that table as a sequence rather than a list. Days introduced at registration cannot be recovered at follow up. They can only be worked around at greater cost. Front End: Preventing the Delay Before It Starts The highest return work in reducing days in A/R happens before the patient is seen. A claim that goes out clean the first time collects in a fraction of the time of one that denies, is reworked and resubmitted. Verify eligibility before every visit, not at registration. Coverage changes, plans terminate and benefits reset. Verification 48 to 72 hours ahead leaves time to resolve a problem before the patient arrives. This is what insurance verification and eligibility checking is for. Capture complete demographic and subscriber detail. A large share of preventable denials trace to a wrong policy number, a missing group number or an incorrect date of birth. Confirm authorisation is obtained and documented before the service is rendered. Prior authorisation management is one of the few places where a process failure creates a denial that is close to unappealable. Establish patient financial responsibility up front and collect at the time of service where possible. Every dollar not collected at the desk enters the slowest and least collectable part of the ledger. Check coordination of benefits where secondary coverage exists, since incorrect primary and secondary ordering is a recurring and entirely avoidable denial. Find Out Where Your Days Are Actually Accumulating Our free RCM audit examines your A/R aging, denial patterns and front end processes, and identifies the specific stages adding days to your revenue cycle. Get Your Free RCM AuditSee Our A/R and Denial ManagementFree audit valued at $1,500. No obligation. USA physician-owned and managed. Mid Cycle: Coding and Clean Claim Submission Clean claim rate is the operational lever most directly tied to days in A/R. A practice submitting at 85 percent clean is reworking roughly one claim in seven, and each rework adds weeks. Submit daily. Batching claims weekly adds days to every claim in the batch for no operational benefit. Work clearinghouse rejections the same day. A rejection is not a denial. It never reached the payer, and it is the cheapest possible fix at the earliest possible point. Run claim scrubbing before submission so coding and

Home›Resources›Blogs›Revenue Cycle Transformation for Multi-Specialty Healthcare Organizations StafGo Health  |  +1 (212) 655-7679  |  stafgo.com  |  HIPAA-Eligible RCM Services Quick Answer Revenue cycle transformation in a multi-specialty organisation means unifying the processes that do not vary by specialty, such as registration, eligibility, payment posting and reporting, while preserving specialty specific coding and payer knowledge. Segmented reporting by service line is the prerequisite for everything else. What This Guide Covers Why multi-specialty is structurally harder What to centralise and what to leave alone Segmented reporting, the prerequisite Standardising the front end across service lines Keeping coding specialised Denial management across service lines Technology and integration Staffing and capability A realistic sequence Frequently asked questions Multi-specialty organisations usually did not design their revenue cycle. It accumulated. A group adds a service line, inherits its billing staff and processes, and repeats. Five years later there are four ways of verifying eligibility, three denial workflows and one aggregate report that conceals all of it. Transformation in this context is not a technology project. It is deciding what should be common, what must stay specialised, and in what order to change them. Why Multi-Specialty Is Structurally Harder Each specialty has different payer behaviour. The same payer applies different policies to cardiology and behavioural health, so a single approach cannot be correct for both. Coding complexity varies widely. A group containing primary care and orthopaedics has service lines with entirely different risk profiles. Authorisation burden is uneven. Some lines require authorisation routinely, others rarely, and a shared team built for average load fails the heavy line. Performance differences hide in aggregates. A strong line subsidises a weak one in the group figure, and nobody sees it. Systems rarely match. Acquired practices bring their own platforms, and integration debt accumulates. Staff capability is uneven. One line may have an experienced biller who knows its payers. Another may not. Per service lineWhere every metric must be measuredCommon coreRegistration, eligibility, posting, reportingSpecialty specificCoding, payer policy, authorisation What to Centralise and What to Leave Alone This is the decision the whole transformation turns on. Function Approach Reasoning Patient registration standards Centralise Data capture requirements are essentially identical across specialties Eligibility verification Centralise the process, vary the benefit detail checked The workflow is common. What is verified differs by service line Prior authorisation Central team, specialty specific requirement matrices Capacity benefits from pooling. Requirements do not generalise Coding Keep specialised The most common transformation error is centralising this Claim submission Centralise Mechanical and identical across lines Payment posting Centralise Rules based, benefits from scale and automation Denial management Central workflow, specialty expertise for appeals Routing and tracking are common. Appeal construction is not Patient billing Centralise Patients with multiple service lines should receive one experience Reporting Centralise, segment by line Common definitions, separated results The centralisation mistake that costs the most Consolidating coding into a single team to reduce headcount. The saving is visible immediately. The denial increase appears one to two quarters later and frequently exceeds it. Coders develop accuracy through repeated exposure to a specialty’s codes, modifiers and payer policies. A generalist coder handling six specialties is less accurate in all six. Segmented Reporting, the Prerequisite This comes before any operational change, because without it you cannot tell where the problem is or whether an intervention worked. Define every metric once, for the whole organisation. Service lines frequently calculate days in A/R differently, which makes comparison meaningless. Report every metric by service line first, aggregate second. The aggregate is for the board. The segmented view is for management. Segment by payer within service line. Payer behaviour differs by specialty, and the interaction is where most actionable patterns sit. Establish baselines before changing anything. Without a baseline, improvement cannot be demonstrated and reversals cannot be detected. Most groups find that segmenting existing data reveals enough to direct the first year of work without any further analysis. See How Each of Your Service Lines Is Actually Performing Our free RCM audit segments your revenue cycle performance by service line and payer, and identifies which lines are carrying the group and which are being carried. Get Your Free RCM AuditSee Our RCM SolutionsFree audit valued at $1,500. No obligation. USA physician-owned and managed. Standardising the Front End Across Service Lines Front end variation is the largest source of avoidable denials in multi-specialty groups, and the cheapest to fix because the required processes are genuinely common. One registration standard. The same demographic and subscriber fields captured to the same completeness standard everywhere. One eligibility verification timeline, typically 48 to 72 hours before the appointment, with specialty specific benefit checks layered on. One authorisation tracking system, with requirement matrices maintained per specialty. One point of service collection policy, applied consistently so patients receive the same experience across lines. See insurance verification and eligibility checking and prior authorisation management for how these operate in practice. Keeping Coding Specialised Specialisation does not mean isolation. The structure that works: Coders assigned to service lines, with enough volume in each to maintain proficiency Common quality standards and audit processes applied across all lines, so performance is comparable Shared documentation feedback loops to clinicians, since documentation gaps recur and clinicians respond better to consistent feedback Cross coverage planned deliberately, with named secondary coders per line rather than ad hoc reassignment Code set update monitoring per specialty, because update cycles differ Accurate medical coding and billing is where specialty knowledge pays for itself, and where its absence is most expensive. Denial Management Across Service Lines Denial workflow can be common. Denial expertise cannot. Element Common or specialised Denial capture and categorisation Common. One taxonomy across the group Routing and prioritisation Common. By value and timely filing proximity Root cause analysis Common method, segmented by service line Appeal construction Specialised. Requires specialty and payer knowledge Payer escalation Common. Group leverage exceeds single line leverage Reporting Common definitions, segmented output Group leverage in payer escalation is a genuine advantage of multi-specialty scale and is frequently unused. A systemic payer error affecting