How to Reduce Days in AR for Your Behavioral Health Practice
You've completed the sessions. Written the notes. Submitted the claims. And now: nothing.
The money you've already earned is sitting somewhere between your practice and the insurance company, waiting. If your goal is to reduce days in AR, you're not alone. The average behavioral health practice currently carries 65 to 75 days in accounts receivable.[1] High-performing practices run at 30 to 45 days.[2] That gap isn't a minor inefficiency. For a mid-size practice, it can represent hundreds of thousands of dollars tied up in unpaid claims.
This post covers why AR days stretch out in behavioral health specifically, and five concrete strategies to bring that number down.
What Days in AR Really Tells You About Your Practice's Financial Health
Days in AR measures the average number of days between rendering a service and receiving payment. It's a clock that starts when you submit a claim and stops when the money lands.
The math is simple: Total AR divided by Average Daily Charges equals Days in AR. Easy to calculate, and revealing to track over time.
Days in AR benchmarks break down like this:
30 days or under: High-performing
40 to 50 days: Average
60+ days: A sign something is systematically breaking down
Behavioral health tends to skew higher than other specialties. Complex program types (ARMHS, CTSS, EIDBI), variable payer rules, prior authorization requirements, and telehealth modifier inconsistencies all add friction to the accounts receivable cycle.
The dollar impact is worth making concrete. A 10-provider group practice in the Twin Cities billing $250,000 per month at 72 days in AR carries roughly $540,000 in outstanding claims. Bring that to 40 days? It drops to $300,000. That's $240,000 in faster cash flow from tightening the AR cycle alone.
Why AR Days Climb in Behavioral Health (And Why Surface Fixes Don't Hold)
Most AR problems start upstream, not at the claim. By the time a claim sits at 75 days, the error happened weeks earlier: at intake, during eligibility verification, or when an authorization expired unnoticed.
Five root causes come up repeatedly in behavioral health billing:
Eligibility not verified. Coverage lapses, deductibles reset, plans change mid-treatment. Assumptions about coverage cause clean-claim failures that push every downstream payment back.
Authorization gaps. ARMHS, CTSS, and other community-based programs have renewal windows that sneak up. When an auth expires mid-month, every session billed after that date gets rejected in bulk.
Documentation and coding errors. Missing medical necessity language, wrong CPT codes, telehealth modifiers left off — claims rejected before they even reach payer adjudication.
No follow-up cadence. Claims submitted and forgotten. Nobody monitors the aging report or makes outbound calls to payers on stuck claims.
Timely filing risk. Most commercial payers allow 90 to 180 days for filing; MN Medicaid windows vary by program.[3] Without active AR tracking, claims quietly slip into uncollectable territory.
Each cause compounds the others. Fix one and the others still create drag.
Consider an ARMHS provider in the Minneapolis metro whose authorization expired mid-October. Three weeks of sessions — more than 60 claims — were submitted without valid auth. All rejected. The error was caught during a billing review six weeks later, already close to timely filing deadlines for the earliest dates of service. Entirely preventable, and unfortunately not uncommon.
Five Strategies to Reduce Days in AR for Behavioral Health Practices
These aren't abstract best practices. They're the specific actions that move the number.
1. Verify eligibility before every session, not just at intake. Coverage changes mid-treatment more often than practices expect. Run real-time eligibility checks before each appointment, especially at the start of each month when deductibles and plans reset.
2. Submit clean claims the first time. Targeting a clean claim rate above 90% is the standard. Every rejection extends AR days by 10 to 30 days minimum. That means accurate CPT codes, correct place of service, complete documentation, and proper telehealth modifiers on the first submission.
3. Build a follow-up cadence and stick to it. Every claim without a response at 10 to 15 days gets a follow-up: a payer call, a status check, or a portal inquiry. Your AR aging report should be reviewed weekly, not monthly. The 31 to 60-day bucket should never be a surprise.
4. Manage denials within 48 hours. Every denied claim needs a named owner, a denial reason code logged, and a next action assigned within two business days. Track denial patterns by payer — if the same modifier keeps getting rejected, that's a systemic fix, not a one-off.
5. Run monthly A/R audits to catch what slips through. Look at aging buckets (0 to 30, 31 to 60, 61 to 90, 90+) to identify where claims are stalling. Anything in the 90+ bucket needs immediate escalation and needs to be understood so the pattern doesn't repeat.
Here's a real example of AR days improvement in action. A solo LICSW in Rochester, Minnesota was checking AR "when things felt slow." After setting up a weekly 30-minute audit, she spotted a specific payer incorrectly rejecting telehealth modifier 95. She resubmitted with corrections and recovered $18,000 in claims she would have eventually written off.
AR Follow-Up Is an Accountability Problem, Not Just a Process Problem
Most practices know what they're supposed to do. The problem is that nobody owns it.
Processes don't follow up on claims. People do. The question every practice needs to answer: who is personally responsible for AR follow-up, and what does their workflow look like this week?
When billing staff, clinical providers, and front desk all share responsibility for A/R management, no one follows up with urgency. Claims age because the accountability is spread too thin.
Dedicated AR management looks like this: one person (or one team) reviews the aging report on a set schedule, logs every payer contact for claims over 15 days, and meets monthly to review trends — which payers are slow, which denial codes keep appearing, where claim volume is growing.
When a practice's internal team doesn't have bandwidth to own this consistently, the cycle gets longer. Not because they don't know what to do, but because it keeps getting bumped for something more urgent. The hidden costs of managing billing in-house add up fast in delayed payments, write-offs, and staff time.
A dedicated billing partner provides the accountability layer: someone whose job is specifically to own your AR performance, track patterns, and bring data to a monthly check-in. One practice tries to manage AR with a front desk coordinator, the treating provider reviewing claims on weekends, and a part-time biller. Another has a dedicated account coordinator who runs a monthly A/R audit, flags aging claims proactively, and brings a performance report to a scheduled check-in. One is hoping the system works. The other has someone who owns the outcome.
Final Thoughts
Reducing days in AR comes down to three things: preventing errors upstream, following up consistently, and having someone accountable for both.
You've already done the clinical work. The delay isn't inevitable. Most of it is preventable with the right processes and the right people in place.
At BreezyBilling, each client gets a dedicated account coordinator who runs monthly A/R audits, follows up on aging claims, and brings performance data to a regular check-in. That's the accountability layer most behavioral health practices are missing — and it's the difference between knowing what to do and actually getting it done.
If your AR days are trending in the wrong direction, we'd be happy to take a look at what's driving it. No pressure, just a conversation.
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Sources
Behavioral Health Billing: Reduce AR Days & Denials — Cloud RCM Solutions, 2025
Days in Accounts Receivable (A/R): RCM Metrics — MD Clarity, 2024
Minnesota Department of Human Services, Medical Assistance Provider Manual — Minnesota DHS, 2025
