Q: Aging report looks fine. Why is cash still late?

The aging report that looks fine landed Monday. Deposits still feel thin. The columns and the bank disagree. Aging only times bills that already exist as receivables. Cash cares about the whole trip from visit to bank. Unbilled work, slow claims, and late deposits can leave you short while the report still looks current. We would start the clock at the visit, not at the column that feels comforting.

Q: Why doesn't my AR report match what hit the bank?

The receivable total looks big. Deposits look smaller. You cannot tell which number to trust. AR is a ledger story. Collections are bank truth. When those disagree, trust the bank first, then find which bucket on the AR report is fiction. We would reconcile the receivable total to deposits before you spend against a number that has not landed.

Q: What's the honest way to clean AR?

Someone reshuffled the aging buckets again. The same dollars are still waiting with fresher dates. Nobody pays you for appearing on a report. Work owned lists by cause and insurance company. Cleanup that only moves dollars between columns leaves the same money uncollected. Status and cause beat age alone. We would rather see fewer balances fixed for good than a prettier aging page.

Q: Should I stop resubmitting claims that already failed the same way?

The history shows the same claim out again and again. Nobody can say why the next try would work. Yes. Put a stop rule in place so the team pauses when the same claim fails the same way. Resubmitting a known dead path burns time and hides the real problem. Fix the cause once, then send a corrected claim, not another copy of the broken one.

Q: Can the age on an aging report be wrong?

A dying claim sits in the current column. It looks young. You know it is not. Yes. Resubmits and date resets can make an old claim look new. The report sorts by a date your system chose, not always by the true life of the bill. Read real claim age before you call a balance current. We would not plan cash on a column that got younger without getting closer to paid.

Q: Does an aging report include unbilled work?

Visits happened. Charges never left. Aging still looks calm because those dollars never appeared. Usually no. Unbilled work never starts the AR clock, so the report misses the first leak. Visits without charges can starve deposits while aging looks fine. We would reconcile yesterday's visits to charges before you call the report current.

Q: Why does my receivables total always look too high?

The AR total keeps climbing. You cannot point to money that will actually land. Overstated AR runs one direction. Dead balances left open, disputed claims still counted as collectible, and write-offs that never got written off all inflate the story. Separate collectible, disputed, and dead before you trust the total. We would rather see an honest smaller number than a big one that will never pay.

Q: Why does days in AR by payer look fine when cash is down?

The payer average looks fine. A few large balances never move. Deposits still lag. Averages hide stuck insurance companies and only count claims that finished. An average that looks fine can sit on top of a few large balances that never move. Read the stuck dollars, not only the mean. We would chase the quiet large ones before you celebrate the average.

Q: What happens when payment posting falls behind?

Money hit the bank last week. The visit still shows open. Nobody knows which is true. Posting is recording the insurance payment or denial against the visit. When posting lags, the AR report lies, denials hide, patient balances rot, and cash looks late even when money already landed. We would clear the posting backlog before you trust aging or chase dollars that are already in the account.

Q: Where does money sit between the visit and the deposit?

The work was real. The deposit is not. You want the dollars named, not another aging column. Most of it sits in a few quiet places: unbilled visits, claims still moving, payments waiting to post, and patient balances on statements. Aging buckets alone cannot see work that never started the AR clock. Put a dollar figure on each step from visit to bank. We would fix the step that holds the most money before you argue about which column looks current.

Question 1

My aging report looks fine. Why is cash still late?

Accepted Answer

Because the report only sees work that was billed, and it sorts by age instead of by whether the money is coming. Visits never billed are missing from it. A balance past its filing deadline sits next to one sent last week, looking the same. Sort it by category instead: active, stalled but recoverable, dead but still listed, and not really owed.

Accounts Receivable Aging Report, Read Properly

Question 2

Why doesn't my AR report match my collections?

Accepted Answer

Because AR records what was billed and is still open, while the collections report records payments recorded in the billing system. Four things sit between them: balances cleared by an adjustment instead of a payment, payments received but not yet recorded, work done but not yet billed, and balances that changed category. Neither report is the bank, and when they disagree with your deposits, the bank is right.

Accounts Receivable vs Collections: Why the Numbers Don’t Match

Question 3

Why does my AR total look higher than what will come in?

Accepted Answer

Because every error in it pushes the total up. Balances past the filing deadline, payments received and not yet recorded, and duplicate charges all make it bigger, and nothing makes it smaller. A balance carried at your full fee does the same when nobody took off the contract discount, the part of your fee the insurance contract says is never paid. Check all four before trusting the total.

Medical Practice AR Cleanup Project That Actually Pays

Question 4

How do we clean up old AR?

Accepted Answer

Sort it by status instead of age: waiting on the insurance company, denied and being worked, denied and untouched, never answered, and taken back. Work the live balances, write off the dead ones on purpose, and report the number that survives the sort. Do it before a lender or a buyer runs the same sort for you. Moving balances between columns doesn’t count as cleanup.

Medical Practice AR Cleanup Project That Actually Pays

Question 5

Can the age on an aging report be wrong?

Accepted Answer

Yes. Aging reports date each claim from its most recent submission, so resending a claim during a dispute resets its age to zero. A five-month fight can sit in the 0 to 30 day column looking fresh. The deadlines don’t reset, because filing limits run from the date of service and appeal windows run from the denial date. Check old claims against the original visit date.

Your Aging Report Is Younger Than Your Claims

Question 6

Does the aging report include visits that were never billed?

Accepted Answer

No. A balance only appears once you bill it, and the industry standard leaves out anything not yet billed. A visit that was documented and never turned into a charge creates no claim, no denial, and no aging line, so nothing alerts anyone. Find them by comparing completed appointments against charges created for the same period. Unbilled care becomes a permanent loss once the filing deadline passes.

Missing Charges: The Visit That Never Got Billed

Question 7

Why does days in AR look fine when cash is down?

Accepted Answer

Because the average hides the one insurance company that slowed down. Days in AR measures how long billed claims take to pay, and blended across every insurer, one slow company barely moves it while it drains your bank. Claims that stall also drop out of the figure. Split days in AR by insurance company, and the one that changed shows up weeks before the cash does.

Days in AR by Payer: Why Averages Look Fine

Question 8

What happens when payment posting falls behind?

Accepted Answer

Four things break at once, even though the cash arrived. AR looks higher than it is, patient statements stall, claims to a patient’s second insurance company wait, and denials sit unread while their appeal deadlines run. Posting means recording each insurance payment or denial against the visit. Compare payment reports received with payments recorded, because a day or two is normal and weeks is a backlog.

Payment Posting Backlog: The Payer Already Told You

Question 9

Why do our billing adjustment codes stop meaning what they say?

Accepted Answer

Adjustment codes, the labels used when a balance is reduced without a payment, are learned on the job and used under time pressure. Someone picks the code that clears an item, the next person copies that choice, and over a few years the list and its real use drift apart. Reports read the code, not the intent. Pull a year of adjustments and check what each code actually did.

Billing Adjustment Code Audit Before Write-Offs Stick

Accounts receivable and the aging report at a medical practice