7 Best Practices for Healthcare Accounts Receivable Management

Accounts receivable management in healthcare is operationally demanding in ways most other industries do not face. Payer rules change constantly, denial rates are rising, clinical documentation requirements are intensifying, and the patients who share financial responsibility are carrying higher deductibles than ever. Within this environment, a few organizational disciplines consistently separate strong performers from the rest. 

1. Claim Scrubbing Before Submission, Not After 

The cheapest denial to manage is the one that never happens. Automated claim-scrubbing tools catch coding errors, missing modifiers, authorization gaps, and payer-specific formatting issues before a claim leaves the building. The Deloitte Center for Health Solutions' 2024 report found that automated claim-scrubbing and predictive validation can prevent up to 85% of avoidable denials, reducing administrative cost per claim by nearly one-quarter. The clean claim rate benchmark is 95% or higher on first submission; organizations falling below that threshold are generating downstream AR problems systematically. 

2. Payer-Specific Follow-Up Cadences 

Generic follow-up intervals do not reflect how different payers actually behave. Medicare pays on a predictable schedule; commercial plans vary widely; Medicare Advantage plans have become the most aggressive source of denials and delays. An effective AR program maintains payer-specific protocol libraries that define when to initiate contact, what documentation to lead with, and when escalation is warranted, rather than applying a uniform cadence across all accounts. For a step-by-step approach to building these cadences, see How to Reduce AR Aging.

3. Denial Integration Into AR Workflows 

Denial management and AR management are often run as separate functions. This creates gaps: a denied claim that should be appealed gets rerouted into a follow-up queue, or an AR account that has already been through the appeals process gets worked again as if it has not. The most effective revenue cycle programs treat denial resolution as a component of AR management — with clear handoff protocols, shared data, and unified reporting that tracks every account from initial submission through final resolution. See AR Management vs. Denials Management: Overlap, Differences, and Why You Need Both for a full breakdown.

4. Triage by Value and Collectability 

Working the largest accounts first sounds logical, but it ignores aging risk. A tiered approach that prioritizes by balance, aging, payer type, and prior response history recovers more per unit of follow-up effort than a simple largest-first queue. Special attention should go to accounts approaching timely filing windows, where the recovery opportunity is time-limited in a way that a purely balance-based approach misses. 

5. Performance Benchmarking at the Payer Level 

Aggregate metrics mask payer-specific problems. A hospital might have acceptable overall AR days while carrying a specific commercial plan with a 25% denial rate or a Medicare Advantage plan routinely paying 60+ days past due. Payer-level benchmarking — comparing each plan's performance against contracted payment terms and industry norms — surfaces these patterns before they become significant AR concentrations. For context on what those norms look like, see AR Aging Benchmarks: Where Does Your Hospital Stack Up?. HFMA's Pulse Survey data show that 22% of healthcare leaders lose at least $500,000 annually to denials alone, with one in ten reporting losses exceeding $2 million annually.

6. Specialist Routing for Complex Accounts 

Not all unpaid claims require the same resolution path. Medical necessity denials and clinical validation disputes require nurse auditors or physician advisors. Coding errors require certified coders. Payer contract disputes require managed care expertise. Routing complex accounts through a generalist billing team is slower and produces worse outcomes than a tiered model that routes accounts to the appropriate specialist based on denial reason.

Initial hospital claim denial rates have concentrated increasingly in medical necessity and clinical documentation disputes — growing to 11–12% nationally in 2024, with the composition shifting toward higher-complexity cases. Organizations that have not built specialist escalation paths into their AR workflow are disproportionately exposed. 

7. Continuous Reconciliation, Not Periodic Reporting 

AR reporting that happens monthly does not catch emerging problems until they are already four weeks old. Leading organizations reconcile their AR inventory continuously — tracking open accounts, documenting payer responses, and identifying accounts approaching escalation thresholds in near real time. This discipline also protects against the risk of administrative closure: accounts marked resolved without a definitive financial outcome, which can inflate the appearance of a healthy AR portfolio while real revenue quietly disappears.

For health systems managing large or complex AR inventories, these practices require both workflow infrastructure and leadership commitment to sustain them. The organizations that execute consistently on all seven — rather than cycling through improvement initiatives that fade when priorities shift — are the ones whose AR performance holds up across payer cycles, system conversions, and staffing changes. For teams looking to accelerate improvement or close performance gaps, engaging a recovery partner structured around these disciplines can deliver results faster than a purely internal buildout.

How Revecore Helps

The seven disciplines in this guide represent what best-in-class AR management looks like in practice. Revecore's AR Management solution is built around all seven — from clean claim submission through continuous reconciliation — with the specialist depth (nurse auditors, certified coders, managed care experts) to handle what generalist teams cannot. For health systems looking to raise the floor on AR performance, we'd welcome the conversation.

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