Get Revenue Moving Again.

Understanding the Operational Root Causes of Reduce Days in A/R

Elevated Days in A/R traps working capital on the balance sheet and signals that claims are stalling in unbilled hold queues, clearinghouse rejections, unworked denials, or inefficient collector workflows.

Total Days in A/R (Total A/R divided by Average Daily Gross Charge over the prior 90 days) is driven by four velocity levers: Charge Lag, First-Pass Clean Claim Rate, ERA Payment Posting Turnaround, and Actionable A/R Workqueue Execution.

Reconfiguring practice management workqueues from alphabetical lists to dollar- and timely-filing-stratified exception queues eliminates wasted collector touches on claims that do not need intervention.

• Decomposition of Days in A/R by aging bucket (0–30, 31–60, 61–90, 91–120, >120), payer, and financial class
• Audit of unbilled encounter holds, coding lag, and clearinghouse 277CA rejection turnaround
• Review of collector workqueue design, touch productivity, and resolution rates per touch
• Separation of credit balances and unapplied cash from true collectible debit A/R

Financial Stakes: Cash Velocity, Net Yield & EBITDA Protection (M–M+ NPR)

Every 5-day reduction in Days in A/R for a $36M healthcare organization releases roughly $500,000 in immediate working capital while reducing >90-day timely filing losses.

When revenue-cycle friction compounds across multiple providers, facilities, or payer contracts, the financial damage shows up twice: first as uncollected cash and elevated Days in A/R, and second as inflated Cost to Collect from manual rework.

What Leadership Should Evaluate First: Forensic Diagnostic Checklist

Before restructuring internal billing teams, issuing an RCM vendor RFP, or purchasing new automation software, leadership should verify the underlying transaction data across the following diagnostic checkpoints:

• Decomposition of Days in A/R by aging bucket (0–30, 31–60, 61–90, 91–120, >120), payer, and financial class
• Audit of unbilled encounter holds, coding lag, and clearinghouse 277CA rejection turnaround
• Review of collector workqueue design, touch productivity, and resolution rates per touch
• Separation of credit balances and unapplied cash from true collectible debit A/R

Common Mistakes Organizations Make When Addressing This Challenge

Healthcare operators frequently lose 6 to 12 months of momentum—and substantial working capital—by treating symptoms rather than fixing the upstream clinical, intake, or technical handoffs driving the problem.

• Artificially lowering reported Days in A/R by writing off collectible >90-day claims instead of collecting them
• Netting large unworked credit balances against aged debit receivables in board reports
• Having collectors check status on 15-to-25 day claims instead of attacking zero-pay denials and >45-day high-dollar balances

30/60/90-Day Advisory & Implementation Roadmap

RCM Advisory Partners structures engagements around clear, measurable milestones designed to protect cash flow during execution:

1. 01
   Days 1–30: Independent Baseline & Transaction Forensics

   Forensic baseline diagnostic of reduce days in a/r across 837 claims, 835 remittances, EHR workqueues, and payer contracts.

2. 02
   Days 31–60: Operating Model Design, Workflow Remediation or Partner Selection

   Execute targeted workflow, claim scrubber, coding, and vendor SLA remediation with weekly leadership checkpoints.

3. 03
   Days 61–90: Execution Oversight, SLA Stabilization & KPI Governance

   Verify net cash collection lift, aging reduction, and first-pass resolution gains and transition into ongoing KPI governance.