For many practices, a growing list of insurance claims sitting in accounts receivable for more than 90 days is discouraging. It is easy to assume older claims have little chance of being paid and should simply be written off. The reality is different.
Claims over 90 days need more attention and strategic follow-up, but they are not automatically uncollectible. Many can still be recovered with the right processes, persistence, and payer-specific expertise.
Understanding aged receivables
Receivables represent money owed for services already delivered. As claims age, they are grouped into time buckets: 0 to 30 days, 31 to 60, 61 to 90, and over 90. Most practices aim to keep the majority under 60 days, but claims past 90 are still recoverable in many situations.
Why claims stay unpaid past 90 days
Some carriers hit backlogs during high volume or system changes. Even clean claims can stay pending for months before final adjudication.
A denial does not mean the claim is lost. Many stem from documentation, coding, eligibility, or authorization issues that can be corrected and appealed successfully.
Payers frequently request additional records before releasing payment. Slow responses extend the claim's time in receivables.
When multiple plans are involved, sorting out the primary and secondary payer can slow reimbursement considerably.
Providers recover substantial revenue through formal appeals. These take weeks or months, pushing claims past 90 days before payment is issued.
Writing off too early hurts
Automatically clearing aged claims may tidy a report, but it carries lasting consequences: lost reimbursement that could have been collected, reduced cash flow, lower collection rates, inaccurate financial reporting, missed appeal opportunities, and increased revenue leakage. Every unpaid claim deserves an individual look before a write-off decision.
Best practices for aged receivables
Recovering a few high-dollar claims often outweighs resolving many small balances. Start where the reimbursement potential is greatest.
Find recurring reasons, whether documentation, coding, authorization, or eligibility. Fixing root causes prevents future aging.
Confirm claim status, document every conversation, and keep momentum toward resolution.
Each payer sets timelines for corrected claims and appeals. Missing them can permanently eliminate reimbursement.
Analyze aging reports by payer, specialty, provider, or denial category. Put effort where recovery is most likely.
When a write-off is appropriate
Not every aged claim is ultimately collectible. A write-off may be right when:
- All appeal rights have been exhausted
- The payer has issued a final denial that cannot be overturned
- The timely filing deadline passed without a valid exception
- The balance is legally or contractually uncollectible
- The cost of further collection exceeds the potential reimbursement
Even then, write-offs should follow established financial policy and include documentation explaining why recovery is no longer possible.
Aged receivables are a signal for focused action, not an automatic write-off. Timely follow-up, effective appeals, and a disciplined process recover revenue many practices assume is gone. Before writing off a claim just because it passed 90 days, evaluate every path to recovery. That extra effort often makes a real difference to the bottom line.
