Cash is the oxygen of any therapy clinic, yet it can evaporate faster than a speech-language pathologist books their afternoon slots. One small slip in follow-up, and that $125 CPT 92507 session might never materialize in the bank. Why does this happen—and why does it persist even in clinics that claim they’ve “closed the loop”?
What exactly is accounts receivable (AR) tracking? Think of it as your clinic’s GPS for money in transit. You billed. The payer acknowledged it (maybe). Now you need a breadcrumb trail showing who owes what, how much, and since when—before claims drift into 90-day purgatory.
Hate spreadsheets? A good AR module syncs ERAs, tags CPT or HCPCS codes, and updates aging buckets in real time. It’s simple—yet strangely elusive.
Rhetorical pause: If AR tracking is that straightforward, why do so many clinics still wrestle with excessive write-offs?
Therapy practices deal with a messier cash flow than primary care clinics. Consider this:
Stack that against razor-thin margins, and AR bloat becomes an existential threat. HFMA pegs average outpatient Days Sales Outstanding (DSO) at 45–50 days—but pediatric PT clinics often creep past 70 when no one is minding the ledger.
Charge Capture: Don’t Let Details Slip
Capture charges within 24 hours. Double-check modifiers (e.g., 59 for distinct procedural service) and place of service codes. A missed modifier today becomes an appeal packet tomorrow.
Claim Submission: Speed Wins
Remittance & Reconciliation: ERA or Bust
When the 835 remittance arrives, auto-post allowed amounts and flag underpayments. Meticulous auditing catches pennies that add up to payroll.
Follow-Up Cadence:
Persistence often triggers payments. Sometimes, a simple "courtesy escalation" call is all it takes.
Ignore "average charge per visit" as an AR health metric. It tells you nothing about speed to cash.
Behavior therapy sessions can rack up 25 hours per week—meaning 25 opportunities for coding mismatches, 25 lines on an 837 file, and 25 potential denials. Add prior authorization lag (hello, Single Case Agreements), and you have a perfect storm.
Each payer’s policy idiosyncrasies don't help—some reject telehealth modifiers while others require them.
Rhetorical question: How do you keep therapists motivated when reimbursement lags two payroll cycles?
Choosing AR tech without a 3-week vendor demo? Start with these filters:
Avoid platforms that claim “AI magic” but hide their logic. If an auditor asks, you’ll need transparency—not a black box.
Simple? Maybe. Effective? Absolutely. Micro-tweaks generate macro gains.
HIPAA fines dwarf unpaid claims. Make sure your AR systems encrypt data at rest and in transit, log PHI access, and maintain clear role-based permissions.
Audits don’t care that your new copay policy crashed your posting workflow—they hit when you least expect it.
Automation crunches numbers; relationships close gaps. Build rapport with payer reps. Know Denise’s extension in Anthem's rehab queue—she might tip you off about claims stuck in limbo.
Old-school? Maybe. Effective? Definitely.
Final Puzzle: In a world chasing full automation, could empathy be the ultimate efficiency hack?
AR tracking isn’t glamorous. It’s a grind through portals, spreadsheets, and payer policies.
Yet with discipline and a bit of creativity, it becomes a strategic lever—fueling payroll, expansion, and patient care.
Clinics that master AR tracking set the rules. Those that neglect it get buried in overdue claims and endless second notices.
Ready to tighten operations?
Start with DSO today. Then iterate—with discipline and purpose—until your 0–30 bucket sings and the 90+ column fades into twilight.
