How to Reduce Days in A/R: A 7-Step Playbook for Podiatry Practices

Independent podiatry practices can deliver excellent care and still feel persistent cash-flow pressure when claims, denials, and patient balances remain unresolved. Days in Accounts Receivable (Days in A/R) helps practice leaders see how quickly billed charges are being converted into cash.

Days in A/R is calculated by dividing total outstanding accounts receivable by average daily charges for the same reporting basis. Broad medical-practice benchmarks commonly place healthy performance around 30 to 40 days, with fewer than 35 days often treated as a strong target. Reaching fewer than 30 days can represent high performance, but it should not be presented as a universal requirement because payer mix, procedure mix, claim complexity, and authorization burden all influence the result.

The goal is not simply to make one dashboard number smaller. A sustainable improvement program shortens charge lag, prevents avoidable rejections and denials, accelerates follow-up, and improves collection of patient responsibility. The following seven steps create that operational discipline.

1. Verify Eligibility and Benefits Before the Visit

Eligibility problems are a common source of avoidable claim rework. Verification should confirm that coverage is active for the date of service and should capture the information needed for the scheduled service, including the correct payer, member details, copay or coinsurance, deductible status when available, referral requirements, and whether prior authorization may be required.

Action step: Run an electronic eligibility and benefits inquiry before scheduled visits, document the response, and route exceptions to a staff member for resolution. Reverify when coverage information changes and at the start of a new benefit year. Treat verification as an estimate of coverage, not a guarantee of payment.

2. Collect Known Patient Responsibility at the Point of Service

Balances become harder and more expensive to manage after the patient leaves. Collecting known amounts at check-in or checkout reduces the volume that must later move through statements, phone calls, portals, and payment-plan workflows.

Action step: Create a written, consistently applied policy for collecting copays, known coinsurance, deductibles, prior balances, and noncovered services. Provide clear estimates and receipts. If the practice uses a card-on-file or electronic payment process, obtain appropriate authorization, protect payment information, disclose when a charge may occur, and follow applicable card-network, state, federal, and payer requirements.

3. Reduce Documentation and Charge-Entry Lag

A claim cannot move until the documentation and charges are complete. Delayed note closure or charge entry adds time before the payer ever receives the claim and can conceal the true source of an A/R problem.

Action step: Establish an internal standard for completing documentation and entering charges, such as by the end of the next business day when clinically and operationally feasible. Use an exception report to identify unsigned notes, missing charges, unposted procedures, and encounters held for clarification. Measure date of service to charge entry and charge entry to claim submission separately.

4. Apply Podiatry-Specific Claim Edits Before Submission

Generic edits may not identify every issue relevant to podiatry. Claim review should account for payer policy and the documentation supporting routine foot care, medical necessity, prior authorization, diagnosis-to-procedure relationships, laterality, anatomical modifiers, and applicable coding edits.

Action step: Configure claim edits around recurring denial and rejection patterns, then update them as payer policies and coding rules change. Use qualified coding review for exceptions. Target a clean claim rate of at least 95%; 98% or higher can be considered high performance when the practice uses a consistent definition.

5. Work Clearinghouse Rejections Promptly

A clearinghouse rejection means the claim failed an edit or transmission requirement and generally has not entered payer adjudication. It should therefore be tracked separately from a payer denial.

Action step: Assign ownership of the rejection queue and review it each business day. Correct and retransmit rejected claims promptly, record the reason, and monitor repeat patterns by payer, provider, location, and error type. Confirm that accepted acknowledgments are being received rather than assuming that transmission equals acceptance.

6. Use Payer-Specific Claim-Status Follow-Up

A single 14-day follow-up rule is not appropriate for every payer or claim type. Follow-up should be based on the payer's expected adjudication window, the claim's submission and acceptance dates, contractual requirements, and the availability of electronic claim-status transactions.

Action step: Build work queues that flag claims when they pass the payer-specific expected response date or show an exception status. Use electronic claim-status tools where available, prioritize high-dollar and time-sensitive claims, and document each action and next follow-up date. Escalate claims that are repeatedly pending or require records, corrections, or payer intervention.

7. Manage Denials by Deadline and Root Cause

A denial is not automatically uncollectible, but delay can reduce the time available to correct, resubmit, or appeal. Filing and appeal limits vary by payer and contract, so a universal five-business-day appeal rule should be treated as an internal service goal rather than a legal standard.

Action step: Capture every denial with its receipt date, reason code, owner, filing or appeal deadline, balance, and next action. Triage high-value and deadline-sensitive cases first. Review denial trends regularly and assign preventive actions to registration, authorization, documentation, coding, charge entry, or billing workflows. Track initial denial rate, final denial rate, overturn rate, and dollars recovered as separate measures.

Measure the Process, Not Just the Final Number

Days in A/R is a lagging indicator. To see what is driving it, review a small set of connected measures each month:

A 30-Day A/R Improvement Plan

Conclusion: Build a Faster, More Reliable Revenue Cycle

Reducing Days in A/R is not the result of one aggressive collection push. It comes from a repeatable system that verifies coverage, collects known patient responsibility, closes documentation, submits accurate claims, resolves rejections, follows payer-specific claim timelines, and manages denials before deadlines expire.

For many podiatry practices, fewer than 35 Days in A/R is a strong operational target, while fewer than 30 days may reflect high performance when it is sustainable for the practice's payer and service mix. The most useful goal is consistent improvement without masking write-offs, inappropriate adjustments, or unresolved balances.

At JARALL Medical Management, we help podiatry practices strengthen revenue-cycle workflows, improve reporting visibility, and address the operational causes of aging receivables. Led by CEO Dr. Alan Bass, a DPM and Certified Professional Coder (CPC) with over 30 years of experience, our team helps you find where revenue is getting delayed and fix it.

Want to know where your A/R is stuck? Schedule a complimentary consultation with JARALL, and we will review your revenue cycle with you.