Discover common causes of high AR over 90 days for home care agencies and proven strategies to improve your revenue cycle and reduce delays in reimbursements.
Introduction
Is your home care agency struggling with accounts receivable (AR) sitting unpaid for over 90 days?
High AR can choke cash flow, delay payroll, and strain daily operations—threatening both your agency’s stability and compliance. In home care, where margins are tight and reimbursement complex, even small delays can snowball into financial risk.
Here’s the good news: most AR problems are preventable, given you develop the right strategies. In this blog, we break down the common causes of AR over 90 days and show you proven solutions to improve cash flow, streamline billing, and protect your agency’s financial health.
Understanding Accounts Receivable in Home Care
Accounts receivable (AR) refers to outstanding payments owed to your agency for services you have already provided. When a client, insurance payer, or Medicaid program has not yet paid for care delivered, that amount sits in your AR balance. In a healthy revenue cycle, payments are collected promptly after billing—but when payments are delayed, AR begins to age.
As you can imagine, “AR over 90 days” specifically refers to invoices remaining unpaid for more than 90 days after the billing date. In home care, this aging threshold is critical because the longer an account remains unpaid, the less likely it is to be collected in full. Older receivables often require more resources to chase down, and they increase the risk of bad debt write-offs.
A strong benchmark in home care is to keep less than 15–20% of your total AR in the 90+ days category. Top-performing agencies often have even lower percentages, 10% or less. If your agency’s AR over 90 days exceeds these benchmarks, it could signal issues with billing accuracy, claims follow-up, payer processes, or internal workflows.
It is essential to recognizing when your accounts receivable is becoming a financial risk—and when it is time to take corrective action.
Common Reasons AR Is Over 90 Days
Several issues can cause a home care agency’s accounts receivable to age beyond 90 days. Understanding these 7 common problems is the first step toward fixing them:
1. Billing Errors and Rejections:
Data entry mistakes, missing documentation, incorrect codes, or not following payer-specific requirements can result in delayed or rejected claims, pushing payments far beyond the expected timeline. For detailed information on Medicare’s claims processes, see the Medicare Claims Processing Manual.
2. Slow Claims Submission:
Delays often begin at the clinical level with incomplete documentation. Without home care software to streamline billing workflows, claims pile up and are submitted late. Understanding Medicare’s payment policies can help improve submission efficiency—refer to Medicare Financial Management Manual for best practices.
3. Ineffective Follow-Up:
When claims are denied, sluggish resubmission or a lack of denial management can leave revenue in limbo. You can streamline the follow-up process by reviewing denial management processes from the Home Health PPS.
4. Authorization Delays:
Missing or delayed prior authorizations and untracked changes in payer requirements can lead to unpaid claims – claims that require extensive back-and-forth to complete. For details on how to manage authorizations efficiently, visit the Home Health Agencies page.
5. Client Eligibility Issues:
If eligibility is not verified at the time of service, claims can be rejected for coverage issues after care has already been provided. For tips on eligibility verification, explore the Coding and Billing Information page from CMS.
6. Poor Internal Workflows:
Disconnected systems and poor coordination between scheduling, clinical, and billing teams create gaps that slow down billing and cash flow.
7. Inadequate Staff Training:
Billing teams not fully trained on payer-specific rules can create frequent errors that delay payment. This can be made worse by knowledge gaps that result from high staff turnover.
Impact of High AR Over 90 Days
When more than 15% of your home care agency’s AR ages past 90 days, the financial and operational consequences can be serious.
Cash Flow Constraints:
Aged AR ties up revenue that should be flowing back into the business. Without timely payments, your agency can struggle to cover daily expenses, invest in resources, and plan for growth.Reduced Ability to Pay Staff and Vendors:
Delays in receiving payments directly impact your ability to pay caregivers, nurses, administrative staff, and critical vendors. This can lead to widespread dissatisfaction, service disruptions, and damage to your agency’s reputation.Increased Audit Risks:
High levels of outstanding AR, especially from Medicaid or Medicare, can trigger scrutiny during audits. Inconsistent billing practices or delayed collections may raise compliance red flags.Higher Write-Offs and Bad Debt:
The longer a receivable remains unpaid, the lower the chance of collecting it. Agencies often end up writing off these amounts as bad debt, permanently reducing revenue.Delays in Agency Growth and Service Expansion:
Tight cash flow from aged AR limits your ability to invest in new programs, expand service areas, or adopt new technologies—stalling your agency’s long-term growth plans.
Keeping AR under control is not just about improving collections; it is essential to protecting the financial health, operational efficiency, and future potential of your home care business.
9 Ways Home Care Billing Software Can Help
Managing accounts receivable requires more than just hard work—it demands the right tools. Home care agencies using outdated systems often face billing delays, missed claims, and rising AR over 90 days. Home care billing software can make a transformational difference.
1. Integrated Billing and Revenue Cycle Management
CareVoyant offers a fully integrated platform that connects intake, scheduling, clinical documentation, EVV, billing, and AR management. This seamless flow eliminates manual data entry between departments, reduces errors, and speeds up the billing process. By streamlining the revenue cycle from the very first patient interaction, agencies can bill faster and more accurately.
2. Real-Time Documentation and Claims Submission
CareVoyant ensures that clinical staff complete notes in real-time, linking services directly to billing workflows. Completed documentation flows automatically into billing so claims can be generated and submitted ASAP. Faster claims submission means faster payments.
3. Proactive Eligibility Verification
CareVoyant’s eligibility verification tools allow agencies to check client coverage in real time during intake and throughout service. Automated alerts notify staff of coverage issues or changes, minimizing denials based on eligibility problems.
4. Authorization and Plan of Care Management
Managing authorizations is critical for preventing unbillable services. CareVoyant offers integrated authorization tracking with proactive alerts for expiring authorizations, so services are delivered only when authorized. This reduces revenue leakage and denials tied to authorization gaps.
5. Denial Management and Resubmission Tracking
With CareVoyant, agencies can establish a strong denial management process. The software tracks denied claims, categorizes them by reason, and provides workflows for timely corrections and resubmissions. Alerts and dashboards ensure that no denied claim slips through the cracks, helping agencies recover revenue quickly.
6. Powerful Dashboards and AR Reporting Tools
Monitoring accounts receivable by aging buckets (30, 60, 90, 120+ days) is easy with CareVoyant’s reporting features. Agencies can identify trends by payer, service type, or branch location, helping leadership correct issues before they impact cash flow. Management by exception ensures teams focus energy only where problems exist, improving efficiency.
7. Reducing Unbilled Claims
Unbilled services are a hidden threat to cash flow. CareVoyant’s exception-based workflows alert staff to incomplete, missing, or incorrectly billed services before they become lost revenue. The system helps agencies minimize billing gaps and maximize collections.
8. Staff Efficiency and Reduced Turnover Pressure
CareVoyant’s helps smaller billing teams accomplish more with less, easing the burden on staff. When manual, repetitive tasks are reduced, your team can focus on high-value activities like managing denials, improving documentation quality, and following up on outstanding claims.
9. Improved Compliance and Audit Preparedness
With CareVoyant’s documentation, billing, and reporting tools, agencies can ensure better compliance with payer regulations and easily prepare for audits. Complete, traceable documentation tied to every billed claim strengthens the agency’s defense during reviews.
In short, CareVoyant’s home care billing software empowers agencies to reduce AR over 90 days, improve cash flow, protect revenue, and position themselves for sustainable growth—even in a challenging reimbursement landscape.
Conclusion
High accounts receivable over 90 days can cripple a home care agency’s cash flow, delay payments to staff and vendors, trigger audits, and stall growth. Common causes include billing errors, slow claims submission, eligibility issues, and poor internal workflows. Fortunately, with proactive strategies—like automating billing, tightening documentation practices, and improving denial management—agencies can take back control.
Effective AR management is not just about survival; it is about driving profitability and long-term success.
Start by evaluating your current AR workflow—and explore how CareVoyant Home Care Billing Software can help you streamline revenue, boost collections, and position your agency for future growth.
Frequently Asked Questions
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It refers to unpaid invoices that have aged beyond 90 days from the billing date. In home care, this indicates serious delays in reimbursement, often tied to billing or documentation issues.
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High AR over 90 days impacts cash flow, delays payroll, increases audit risk, and can lead to bad debt write-offs—all of which threaten the financial stability and growth of your agency.
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A strong benchmark is keeping under 15–20% of your total AR in the 90+ days category. Top-performing agencies often maintain 10% or less.
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Common causes include billing errors, slow claims submission, lack of follow-up on denials, missing authorizations, eligibility issues, poor internal workflows, and untrained billing staff.
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CareVoyant Home Care Billing software automates workflows, speeds up documentation, submits claims faster, tracks denials, verifies eligibility, and alerts staff to issues—all helping to reduce AR aging.
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Yes. A strong denial management system ensures faster resubmission of rejected claims, minimizes lost revenue, and keeps AR aging under control.
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Incomplete or late clinical documentation slows down claim generation and submission, leading to delayed payments and increased AR over 90 days.
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Agencies should align intake, scheduling, documentation, and billing processes; verify eligibility upfront; manage authorizations proactively; and invest in training staff on payer-specific billing rules.
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CareVoyant provides real-time dashboards, AR aging reports, denial tracking, and exception-based alerts so agencies can quickly act on billing issues before they age past 90 days.
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Start by reviewing your current billing and documentation processes, audit your AR aging reports, train your billing team, and explore tools like CareVoyant Home Care Billing Software that automate and streamline your revenue cycle.
About CareVoyant
CareVoyant is a leading provider of cloud-based integrated enterprise-scale home health care software that can support all home-based services under ONE Software, ONE Patient, and ONE Employee, making it a Single System of Record. We support all home based services, including Home Care, Private Duty Nursing, Private Duty Non-Medical, Home and Community Based Services (HCBS), Home Health, Pediatric Home Care, and Outpatient Therapy at Home.
CareVoyant functions – Intake, Authorization Management, Scheduling, Clinical with Mobile options, eMAR/eTAR, Electronic Visit Verification (EVV), Billing/AR, Secure Messaging, Notification, Reporting, and Dashboards – streamline workflow, meet regulatory requirements, improve quality of care, optimize reimbursement, improve operational efficiency and agency bottom line.
For more information, please visit CareVoyant.com or call us at 1-888-463-6797.
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