Understanding and improving medical billing accounts receivable (A/R) is essential for private practices. It shows where money stalls, where workflow can improve, and how quickly payments arrive.

When accounts receivable move faster, healthcare providers can plan confidently, and patients get a smoother experience. Timely reimbursements from payers and insurance companies support predictable operations and fewer billing surprises at the front desk.

Improving A/R in medical billing starts with clear handoffs, clean claims, and a consistent workflow supported by automation and strong revenue cycle management (RCM).

In medical billing, accounts receivable (A/R) is the money a practice is owed for care already provided. These are balances due from patients and from payers via insurance claims and reimbursements.

In a healthcare practice, A/R spans the patient, front office, providers, and billing staff; each handoff in the billing process affects how fast a balance clears from the patient's account.

Core A/R work includes eligibility checks, coding, clean-claim submission, payment posting, payer follow-up and denial management, patient billing and collections, and reporting that guides the A/R process and overall workflow. Most practices manage A/R in an electronic health record (EHR), using the  EHR software to connect front-office tasks, insurance claims, and the billing process.

A/R moves through a predictable collection process. Tight handoffs cut errors and keep payments on schedule.

Done in sequence, these steps speed reimbursements and reduce outstanding payments.

Track a small set of core metrics to catch issues early and protect your practice's financial health. Compare results to payer and industry benchmarks so trends are obvious, not hidden.

Assessing and comparing performance is essential to success. For example, billing specialist Diane Allison said that if a practice's clean claims rate is less than 95%, it's losing money. 

"To calculate the clean claims rate, divide the number of clean claims by the total number of claims submitted and multiply the result by 100."

(Clean claims rate = (clean claims ÷ total claims) × 100)

Another key metric is the denial rate: 

(Denial rate = (denied claims ÷ total claims) × 100)

An experienced A/R expert herself, Allison declared that the denial rate should be less than 5%.

Use real-time dashboards to isolate outliers and apply the CMS improper payments methodology to categorize errors and track fixes over time.

Effective denial management starts by grouping the reasons behind claim denials and rejections. That way, fixes happen at the right point in the workflow.

What to do first: Turn on front-end edits, keep a root-cause log by payer, and publish payer-specific rules so teams fix issues once and not repeatedly. Standardize these practices with Tebra's denial management strategies and use the Q&A on claims and denials to train staff. 

Close the loop with clear, documented communication to insurance companies. Use portals, note calls, and confirm adjustments in writing to shorten appeal cycles and support timely payments.

Clear roles and effective communication keep healthcare organizations' A/R moving. Here's how the front office, provider, and billing office plus A/R team connect.

"Keeping an open communication with your front office staff and partnering with your providers as well as your office admins will drive down those pain points, those inefficiencies," Allison said. Strong, effective communication applies whether you work in-house or with billing companies.

Patient balances now account for more revenue across the healthcare industry. Practices that focus on improving patient collections protect healthy cash flow and strengthen AR management.

Use these three steps to streamline your collection process and protect healthy cash flow.

Spell out co-pays, deductibles, payment plans, and how outstanding balances are handled. Note who owes what if a claim is denied. Include your fee for missed appointments policy.

Explain where federal law dictates advance price communication for Medicare and commercial plans. As Allison said, "A transparent, consistent, and defined financial policy can alleviate both A/R issues and patient frustration." Clear rules reduce payment delays in the payment process.

Use text and email reminders delivered automatically through your portal. Add QR codes to paper statements. Offer cards, wallets, ACH, and save-on-file. Automation helps streamline patient payment. It also trims manual A/R follow-up and prevents delayed payments.

Map each stage of the collection process with timelines and dollar thresholds. Define when to set a plan, when to escalate, and when outsourcing is appropriate. 

Track notes and status codes so accounts receivable management stays accurate and auditable. As Allison emphasized, "Documenting your internal collection protocols is crucial."

To improve A/R, take a 2-pronged path: reduce claim denials and accelerate patient collections. Together, these steps tighten your workflow, lead to timely payments, and build long-term financial stability for your practice.

For an integrated approach, Tebra pairs billing and patient payments with built-in automation so teams can verify eligibility, submit clean claims, post remittances, and trigger follow-up in one place. 

That makes it easier to apply what works, measure results, and scale without adding overhead.