Direct answer
As of August 2026, a medical practice should review accounts receivable by aging, payer, provider, location, responsibility, claim status, denial reason, and collectibility. The total balance alone cannot show whether the practice has a submission problem, a follow-up problem, a posting problem, or balances that should be adjusted or written off under approved policy.
Reconcile billing activity to cash and the accounting records
Tie charges, contractual adjustments, payments, refunds, write-offs, and ending receivables across the practice-management, bank, and accounting systems. Investigate unexplained differences before relying on collection metrics.
Segment receivables by the action required
Separate unsubmitted claims, rejected claims, pending claims, denials, payer follow-up, patient responsibility, credits, and balances under appeal. Assign an owner and next action instead of treating all aged dollars alike.
| Receivables view | Management question |
|---|---|
| Unsubmitted and rejected | Why has the claim not entered adjudication, and who must correct it? |
| Pending claim status | Is the claim in process, suspended, awaiting information, or past the expected response date? |
| Denials | Which reasons recur by payer, provider, code, location, or workflow? |
| Patient responsibility | Are statements, payment options, collections, and financial-assistance policies applied consistently? |
| Credits and refunds | Are overpayments identified, researched, approved, and resolved under applicable rules? |
| Accounting reconciliation | Do billing activity, deposits, refunds, adjustments, and the ledger agree? |
Review trends without inventing a universal benchmark
Compare aging, denial categories, collection timing, and adjustment patterns with the practice’s own contracts, specialties, locations, and prior periods. External benchmarks can inform questions, but they do not replace a reconciled practice-specific baseline.
Connect receivables to decisions
Use receivables findings to adjust staffing, billing-vendor oversight, payer follow-up, patient collection procedures, cash forecasts, and contract discussions. Clinical coding and compliance questions should go to qualified billing and compliance professionals.
Primary sources
Frequently asked questions
Is days in accounts receivable enough to manage collections?
No. A single average can hide old balances, payer concentration, denials, patient balances, credits, and data-quality problems. Use it with aging and action-based detail.
Should old receivables always be written off?
No. Review collectibility, contract terms, documentation, appeals, patient policies, applicable law, and approval authority before adjusting a balance.
Can a CPA determine whether a medical claim was coded correctly?
Not by default. A CPA can reconcile financial activity and analyze trends; qualified coding, billing, legal, and compliance professionals should address claim-specific rules.