Insurance Aging
Dental RCM Glossary
The tracking of unpaid insurance claims by the number of days since submission to monitor collection performance.
Insurance aging is the process of tracking and categorizing unpaid insurance claims based on the number of days that have elapsed since the claim was submitted to the payer. Claims are organized into aging buckets, typically 0-30 days, 31-60 days, 61-90 days, and over 90 days, to provide visibility into the age distribution of outstanding insurance receivables. The insurance aging report is one of the most important financial management tools in dental revenue cycle management, as it reveals how effectively the practice is converting submitted claims into collected payments and identifies claims that require follow-up intervention.
Healthy insurance aging metrics for a dental practice generally show 70 percent or more of insurance accounts receivable in the 0-30 day current bucket, less than 15 percent in the 31-60 day bucket, less than 10 percent in the 61-90 day bucket, and less than 5 percent in the over-90-day bucket. When a significant percentage of claims ages beyond 60 days, it indicates problems in the billing workflow such as unworked rejections, unappealed denials, or failure to follow up on pended claims. Claims that age beyond 90 days face increasing risk of exceeding payer timely filing limits, at which point they become permanently uncollectible regardless of their validity.
From an operational standpoint, the insurance aging report should be reviewed weekly by the billing team and monthly by practice leadership. Each aging bucket requires a different follow-up strategy. Current claims in the 0-30 day range are monitored for normal processing. Claims in the 31-60 day range should be checked for status with the payer. Claims at 61-90 days require escalated follow-up, including resubmission if the original claim cannot be located by the payer. Claims over 90 days need immediate attention to determine whether they are still within the filing deadline for appeals or resubmission. Segmenting the aging report by payer reveals which carriers are consistently slow to pay or problematic to collect from.
Why It Matters for Dental Practices
Claims over 90 days old have significantly reduced collection probability. Monitoring insurance aging by bucket and payer enables practices to prioritize follow-up efforts on claims most at risk of becoming uncollectible.
Example
A practice's aging report shows $45,000 in insurance A/R over 60 days, with $18,000 of that concentrated on one carrier. The billing team escalates follow-up with that carrier and discovers a batch of claims were lost, requiring immediate resubmission.
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