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Recovering these claims efficiently isn’t just a back-office chore. It’s a vital strategy that improves cash flow, reduces bad debt, and frees up financial resources to invest in what matters most: patient care and organizational growth. In this blog, we’ll break down why aging medical claims matter, what causes them to pile up, and the step-by-step process you can use to recover them faster and more effectively.
What Aging Medical Claims Are and How They Affect Your Revenue Cycle
For healthcare organizations, aging claims represent one of the most persistent threats to healthy revenue cycles. But what exactly qualifies as an “aged” claim, and why should they command your attention?
Definition of Aging Claims
Put simply, aging claims are unpaid medical claims that have not been resolved or reimbursed within a standard time frame—often 30, 60, or 90+ days after submission. The longer claims sit unpaid, the more difficult they become to collect.
While some aging is natural given payer timelines and complexities, excessive aged claims signal underlying issues that need attention.
The Financial Risks of Aging Claims
Every day a claim sits unpaid, it represents cash that isn’t in your account to cover salaries, buy supplies, invest in new technology, or improve patient services. Aging claims:
- Disrupt cash flow and make financial forecasting difficult.
- Increase the likelihood of denials or missed filing deadlines.
- Risk becoming bad debt if left unresolved for too long.
Allowing aging claims to linger ultimately compromises your organization’s financial health. That’s why proactive management and timely resolution are essential.
Step-by-Step Guide to Recover Aging Medical Claims Faster
While aged claims can feel overwhelming, the right approach can help you turn the tide and recover revenue efficiently. Here’s how to take control of your healthcare accounts receivable and tackle aging claims head-on.
Segment and Prioritize AR by Age and Value
Not all aging claims are the same. Start by organizing your accounts receivable into logical segments based on:
- Age of the claim (30-60 days, 60-90 days, 90+ days)
- Claim value (focus on higher-dollar amounts first)
- Filing deadlines (claims nearing their timely filing limit require urgent attention)
This segmentation helps ensure that your resources are applied where they will make the biggest impact.
Identify Claim-Specific Issues and Payer Trends
Once claims are segmented, it’s time to diagnose the problem. Review each aged claim to determine:
- Denial reasons, if any
- Missing or incorrect documentation
- Payer-specific trends that indicate systemic issues
Are certain payers consistently slow to pay? Do particular procedures or codes generate more denials? Spotting these trends allows you to take corrective action and prevent similar delays in the future.
Conduct Targeted Follow-Ups (Automated and Manual)
Follow-up is where the heavy lifting happens. Combine automated and manual tactics to maximize efficiency:
- Automated systems can handle standard follow-ups on routine claims, ensuring nothing slips through the cracks.
- Manual intervention is essential for complex claims, payer escalations, and accounts requiring nuanced communication.
Regular, persistent outreach is critical. The more often you check in on aging claims, the harder it is for them to go unresolved.
Resubmit or Escalate When Necessary
Sometimes, claims aren’t aging because of inactivity, but because they were denied or require correction. When appropriate:
- Correct any errors or omissions and resubmit the claim promptly.
- If the claim is unjustly denied or unresolved, escalate to payer representatives or appeals processes to push for resolution.
Don’t accept stagnant claims at face value. Keep pushing until you reach a final determination.
Track Resolution Rates and Apply Learnings
Finally, successful recovery doesn’t stop at getting paid. Tracking your success rates and understanding why claims aged in the first place closes the loop.
- Monitor key metrics like resolution rate, recovery amounts, and days to resolve.
- Share findings with front-end, coding, and billing teams to prevent recurrence of avoidable aging issues.
Continuous improvement is essential to reducing aging claims over the long term.
Aging claims slowing down your cash flow? Explore Horizon Healthcare’s revenue cycle management solutions to recover faster and keep your financial performance on track.
Why Do Medical Claims Age?
Not every aging claim is the result of negligence. Often, they stem from preventable issues throughout the revenue cycle.
Payer Delays and Complexities
Insurance companies don’t always move quickly. Reviews, policy updates, and internal processing delays can push payment timelines far beyond what providers expect.
Additionally, changes in payer requirements—such as prior authorizations, updated codes, or additional documentation—can cause claims to be held up or returned.
Missing or Incomplete Documentation
One of the most common reasons for claim aging is missing or incorrect information. This could be as simple as a wrong patient identifier or as complex as a lack of clinical documentation to support the procedure performed.
When documentation is incomplete or doesn’t align with payer guidelines, claims get stuck in limbo until the gaps are resolved.
Lack of Timely Follow-Up
Revenue cycle teams are often stretched thin, balancing new claims submissions with denial management and appeals. As a result, aged claims can fall to the bottom of the priority list.
Without consistent and strategic follow-up, aging claims slip through the cracks, missing timely filing deadlines and reducing the chances of successful reimbursement.
Why Partnering With Experts Simplifies the Recovery Process
Managing aging claims requires skill, persistence, and bandwidth—something many internal teams are short on. Partnering with an expert denial management services provider can help turn a reactive process into a proactive revenue strategy.
Access to Proven Processes and Tools
Specialized partners bring advanced technology, payer knowledge, and proven workflows to the table. This allows them to quickly segment claims, identify issues, and execute effective follow-up faster than stretched internal teams can manage.
Free Up Internal Resources
Revenue cycle staff are often pulled in many directions. Outsourcing aging claim recovery allows internal teams to focus on:
- New claims processing
- Front-end improvements
- Patient financial communication
Meanwhile, expert partners handle the heavy lifting on aged accounts.
Increase Recovery Rates and Cash Flow
With dedicated focus, denial management experts help organizations recover revenue that would otherwise go uncollected. In doing so, they:
- Reduce write-offs
- Shorten revenue cycle timelines
- Improve cash flow reliability
Aging claims become an opportunity for recovery instead of a drag on performance.
Take Control of Aging Medical Claims With Horizon Healthcare RCM
Aging medical claims don’t just go away. Left unaddressed, they quietly chip away at revenue, increase bad debt, and limit your organization’s financial agility.
But it doesn’t have to be that way. With the right approach — one built on prioritization, analysis, strategic follow-up, and continuous improvement — you can recover aging claims faster and more efficiently.
At Horizon Healthcare RCM, we help healthcare providers take back control of their healthcare accounts receivable. Our denial management solutions are designed to minimize aging, recover unpaid medical claims, and strengthen your revenue cycle from every angle.
Ready to close the gap on aging claims and improve your financial performance? Contact Horizon Healthcare RCM today to learn how we can help you recover more, faster, and with less effort from your team.
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