In most healthcare organizations,accounts receivable over 120 days are considered aged. By 180 days, it is oftentreated as effectively lost. Across physician groups and multisite providers:
- Industrybenchmarks suggest that a meaningful share of AR—often in the mid-teens tomid-twenties percentage range—sits beyond 120 days
- Even indental and outpatient settings, it is not uncommon to see 8–12% of total AR in120+ day buckets.
At the same time, historicalbenchmarks suggest that recovery rates for AR beyond 180 days can still bematerial, often in the low double-digit range depending on payer mix andfollow-up quality. That’s low enough to discourage focus. High enough tomatter.
In practice, most providers do something in between. They leave it.
Why Old AR Isn’t Worked
It is rarely a single decision. Itis a set of assumptions that quietly reinforce each other:
- Too mucheffort— Aged AR is seen aslow-probability, high-effort work.
- Trade-offs. It competes with newerclaims — Teams prioritize recent submissions where reimbursement feels morecertain.
- Stuck. It’s difficult to hand off — Outsourcing old AR is assumed torequire significant training, system access, and coordination.
Over time, aged AR becomes aseparate category. Not quite written off, but not actively managed either. Thereis a tendency to treat old AR as the lowest-value work in revenue cycle. But itis not unearned revenue. It is earned revenue that has already absorbed costand is now sitting idle.
A different model for cold cases
we have built the capability totackle cold case AR with a deliberate focus that changes the structure of theproblem.
- Laser Focusstarting point. Instead oftaking the entire AR book, the work begins with the backlog of old AR.
- Data-driventriage. Claims segmented by likelihood topay Effort directed toward recoverable pockets.
- Expertise oncontext. Strategy adapted to payer behaviorand documentation gaps.
Just as importantly, the operatingmodel removes friction:
- Nolarge-scale tech implementation
- No extensivetraining or handoff period: the team hasdeep expertise to apply to working on old AR and can move independently; youcan ringfence this from your daily work on revenue cycle.
- No switchinggears: Work can begin without pullinginternal teams away from current AR
For multisite providers, thisallows aged AR to be addressed without disrupting operations.
Rethinking what is hard
Old AR is often treated as thehardest part of revenue cycle. But it is also one of the most mischaracterizedopportunities. With a focused, data-driven approach, it becomes less aboutchasing unlikely dollars and more about recovering what has been overlooked.
What looks like the least attractive work can, in the right structure, becomesome of the most valuable.
