By Brandon Seigel, Chief Problem Solver · September 23, 2026 · 6 min read
The buckets
Most reports group balances into 0–30, 31–60, 61–90, 91–120, and 120+ days. Money in the early buckets is normal. Money piling up in the later buckets is a warning.
What healthy looks like
The goal is simple: most of your insurance A/R should sit in the first 30 days. The older a claim gets, the harder it is to collect — and the closer it gets to a filing or appeal deadline.
Why claims get old
Old A/R almost always traces back to a few causes.
- Denials nobody worked
- Claims that never reached the payer
- Payments received but not posted
- Missing authorizations or referrals
- Patient balances nobody followed up on
How to bring it down
Work the oldest, largest balances first. Separate insurance A/R from patient A/R. Then fix the root cause, so the same claims don't age again next month.
Daily work beats periodic clean-ups. When claims, payments, and denials are handled every business day, A/R stays young.
Quick answers
What is a good A/R over 90 days for a therapy practice?
Lower is better. Most of your insurance A/R should be under 30 days old; a growing 90+ bucket usually means denials or unposted payments need attention.
How often should I review A/R aging?
At least monthly as an owner. Your billing team should be working it every business day.
See exactly what's included in our medical billing services for therapy practices, how our percentage-of-collections pricing works, or browse common questions from practice owners.
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