A/R Health Is More Than Just Aging
January 2026
Aging reports remain an essential tool—but they are only one lens. True A/R health is measured by the entire revenue cycle, not simply by how much sits in the 120-day column. In many oral surgery practices, accounts receivable (A/R) health is reduced to a single metric: how much money is sitting in the 120-day aging bucket. While aging reports are important, focusing solely on balances over 120 days provides an incomplete—and often misleading—picture of a practice’s true financial performance.
A/R health is not about how long money has been outstanding in isolation. It is about how efficiently, accurately, and predictably revenue moves from procedure to payment across a complex mix of insurance, patients, and third-party payers.
Aging Buckets Show Symptoms, Not Root Causes
It is true that the 120-day column is a lagging indicator. By the time a balance reaches that point, the underlying issue has already occurred—often weeks or months earlier. Common root causes include:
Eligibility or benefit verification errors at intake
Incorrect CDT coding or mis-tiered procedures
Missing documentation for medical or dental cross-coding
Delays in claim submission or resubmission
Inadequate follow-up on denied or pended claims
However, not all balances that reach 120 days reflect a breakdown in process.
Context Matters: Coordination of Benefits, Clinical Complexity
Evaluating A/R health without accounting for COB status and procedure complexity can lead to false conclusions and unnecessary operational pressure. Context matters. In oral surgery and specialty dentistry, it is common for claims to pass through multiple payers before final resolution. Coordination of benefits (COB), particularly when medical and dental carriers are both involved, can legitimately extend the lifecycle of a claim well beyond 90 or even 120 days. Claims may require:
Processing and adjudication by a primary payer
Issuance of an explanation of benefits (EOB) before secondary submission
Manual review by secondary or tertiary carriers
Additional documentation requests at each stage
In these cases, a claim aging beyond 120 days is not necessarily delayed, mishandled, or unpaid—it may simply be moving through a required sequence of payer determinations. Moreover, OMS claim complexity can also distort simple aging metrics. Since procedures are inherently more complex, practices often manage high-dollar surgical cases, trauma and pathology, and hospital-based or out-of-network services. A single complex case awaiting multi-payer resolution can materially impact aging reports without signaling poor A/R management.
A More Accurate Definition of A/R Health
A/R health is therefore not defined by an arbitrary aging threshold but rather characterized by:
Claims that move predictably through payer sequences
Clear visibility into which balances are pending versus stalled
Strong follow-up discipline aligned with payer timelines
Minimal rework caused by preventable errors
Curious About Your A/R?
Get clarity with our Accounts Receivable Health Check which provides a thorough, data-driven review of your billing, offering insights into next steps to strengthen your bottom line. Our billing and consulting services are customized to each practice’s specific needs and goals. Call or text us at (860) 435-7344 any time for a free consultation on how we can support you in optimizing your practice today.
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