Medical groups carry an average of 35–40 days in A/R, according to MGMA's 2023 Cost and Revenue Survey — but top-quartile practices collect in fewer than 30 days. That gap isn't cosmetic; on a $3M annual revenue practice, the difference between 28 and 42 days in A/R is roughly $115,000 sitting uncollected at any given moment. If you track only one billing metric, days in A/R is it.
Why Days in A/R Signals More Than Just Speed
Days in accounts receivable (A/R) measures the average number of days it takes your practice to collect payment after a service is rendered. The formula is straightforward: divide your total outstanding A/R balance by your average daily charges. The result tells you how efficiently your revenue cycle converts clinical work into cash.
The problem most practices face isn't that they've never heard of days in A/R — it's that they check it infrequently, benchmark it against the wrong peers, or confuse a passable number with a good one. A practice billing across five payers with a mix of commercial, Medicare, and Medicaid claims can post a blended days-in-A/R figure that looks acceptable while hiding serious deterioration in one payer segment or one provider's claim volume.
Specialty mix compounds this further. A primary care group and an orthopedic surgery group will not have the same days-in-A/R target — and comparing them directly without specialty adjustment produces useless conclusions. This is where practices lose money quietly: the metric looks fine in aggregate while problem buckets go unaddressed for months.
What the Industry Benchmark Actually Says
MGMA data consistently places median days in A/R between 35 and 40 days across primary care and multispecialty groups. Top-quartile performers sit below 30 days. High-complexity specialties — orthopedics, neurosurgery, interventional cardiology — may run 40–50 days without it representing a performance failure, provided their denial rate stays under 5% (AAPC benchmark) and their net collection rate stays above 95% (MGMA benchmark).
The benchmark only means something in context. A 38-day figure with a clean aging bucket (less than 15% of A/R over 90 days) is materially different from a 38-day figure where 30% of balances are aged past 90 days. The number on the surface hides the risk underneath — which is exactly why your revenue cycle analytics view needs to show aging distribution alongside the headline metric.
What Good Looks Like in a Well-Run Practice
A well-managed independent practice with a mixed commercial and Medicare payer base targets days in A/R between 28 and 34 days. Claims are scrubbed and submitted within 24–48 hours of service. Denials are worked within 5 business days. The front desk verifies eligibility on 100% of scheduled appointments, not as a policy statement but as a measurable daily output.
High-performing groups also segment their A/R by payer. Commercial payers should clear faster than government payers; if your Medicare A/R is aging faster than your BCBS A/R, that's a coding or documentation issue, not a payer issue. Practices using a daily analytics dashboard catch these shifts in real time rather than discovering them at month-end when the window to appeal has narrowed.
Specialty matters, but it's not an excuse. A dermatology group running 50 days in A/R has a billing problem, not a specialty problem. Use MGMA specialty-specific benchmarks as your ceiling, not your target.
Want to see exactly where your practice stands on Days in A/R? Use the free RCM Benchmarking Scorecard → — compare your metrics against MGMA benchmarks in under 5 minutes.
How to Improve Days in A/R
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Shorten your charge lag. Charges not submitted within 48 hours of service add direct days to your A/R. Audit your charge entry workflow weekly and set a hard internal target of same-day or next-day charge posting.
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Segment A/R aging by payer and provider. A blended aging report obscures where the problem lives. Break your A/R into buckets — 0–30, 31–60, 61–90, 90+ days — for each payer and each provider, then address the worst buckets first.
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Work denials within 5 business days. AAPC data shows that denial rates above 5–7% correlate directly with elevated days in A/R. Assign ownership to specific denial categories and track resolution time, not just denial volume.
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Verify eligibility before every visit. Real-time eligibility verification reduces avoidable rejections at submission — the single fastest way to pull days out of your A/R without changing your fee schedule or renegotiating contracts. Build this into your scheduling workflow, not your billing workflow.
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Set a 90-day A/R threshold and enforce it. Any balance older than 90 days that hasn't been appealed or escalated is effectively a write-off in progress. Establish a protocol: at 60 days, a follow-up call; at 75 days, a formal appeal or secondary billing; at 90 days, a decision point.
The Data Visibility Problem Behind Every Slow A/R
Most practices that struggle with days in A/R don't have a billing team problem — they have a visibility problem. When your RCM data lives inside your practice management system and surfaces only in static monthly reports, your team is always reacting to last month's numbers. By the time a denial trend or charge lag shows up in a report, it's already 30 days old.
The practices that consistently hold days in A/R below 32 days treat their billing data the same way a supply chain manager treats inventory: as a daily operational signal, not a monthly accounting exercise. If you're not sure where your practice stands today, the Harine Management Practice Health Score gives you a structured read on your A/R performance against MGMA benchmarks in about five minutes — no commitment required. And if you're a PE-backed group or investor evaluating a platform practice, due diligence analytics surfaces exactly these patterns before close, not after.
If you already know your Days in A/R is too high, the Revenue Leakage Calculator will put a dollar amount on what it's costing you each month. You can find it alongside other free diagnostic tools in the Harine Management free tools library.