Thumbnail Playbook Work Old Ar
Working Aged Receivables

Difficulty: Simple  //  COVID-19

Why run this play?

This play is valuable because hidden cash often lives in many places in Aged Receivables. Working Aged A/R also provides an opportunity to clean up the subledger detail with small balance write-offs and other write-offs which in many cases are fully reserved on the G/L.


In many cases, COVID-19 is showing the A/R < 30 is less than normal as provider census and volumes have declined particularly for electives and scheduled non-emergent and/or non-critical care. In some cases current A/R is down by 30-40%. This presents an opportunity to shift a portion of Account Rep Follow-Up time to older A/R where in many cases accounts don’t receive as much critical attention – whether complex managed care claims, small balances or problematic accounts that are in a status as denied, partially denied or underpaid, not to mention, accounts that are just dormant and awaiting attention.  

Take Action

A great way to make real progress is to determine and outline a segmentation strategy that codifies the accounts for action by payment disposition and/or follow-up status or activity code.  Initially, determine if the account has been billed as accounts can slip through the cracks. Should it be re-billed? Is there an active root-cause remark (CARC/RARC and other remark codes) readily available? Segment accounts for follow-up efficiency. For example, if accounts are awaiting payment due to missing or incomplete information which can be gathered quickly, then separate those accounts from claims that require deeper research or intervention such as coordination with HIM or Case Management.

The following are some examples of key Claim Follow-Up Segments which can help with organizing a Follow-Up Segmentation Strategy:

  • Promise to Pay Date - Payer 
  • Promise to Pay Date - Patient / Guarantor
  • Missing Information - Claim Incomplete
  • Missing Information - Clinical / Medical Necessity Requirements
  • Missing Information - Attachments Required
  • Denial Root Cause:  Administrative (Claim & Billing based Denials)
  • Denial Root Cause:  Clinical / Medical Necessity
  • Underpayment - Payer
  • Underpayment - Patient/Guarantor
  • Overpayment - Payer
  • Overpayment - Patient/Guarantor
  • Adjustment Processing - Administrative
  • Adjustment Processing - Bad Debt / Write-Offs
  • Account Transfer to Agency - Collection Agency
  • Account Transfer to Agency - Specialty A/R (TPL / Liens / Complex Denials)
  • Small Balance Write-Off
  • Credit Balance Processing - Adjustment Reconciliation
  • Credit Balance Processing - Refund Patient / Guarantor
  • Credit Balance Processing - Refund Payer
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How to Calculate This Play's Value

We recommend setting incremental cash targets by leveraging historical data and determining Experiential Net Revenue (ENR) by Payer/FC/Ins1 and by Age Bucket.  Set stretch goals by determining a reasonable stretch percentage such as 5-10% above normal thresholds.

We also recommend measuring weekly and celebrating small victories.  

Note:  For VisiQuate Clients, please let us know if our Account Managers can assist you in setting up segments and developing any custom reports in this regard in your Site.

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