AR Aging Follow-Up for SNF & LTC
Aged AR worked the way your CFO would do it, every day. 0-30, 31-60, 61-90, 91-120, and 120+ buckets. Payer-specific cadence. 276 and 277 claim status transactions. Root-cause categorization. Write-off versus appeal decisions logged with sign-off. 800+ providers trust us. Pilot in 2 weeks.
0:55
0:48AR over 90 is climbing. DSO is creeping. Nobody owns the queue.
Aged AR rarely fails because the claim was wrong. It fails because no one called the payer back this week. Or last week. SNF AR over 90 frequently sits above 25 percent of total AR at facilities without dedicated follow-up. Every uncollected dollar past 120 days is a dollar likely to be written off.
AR over 90 is climbing
Without a dedicated AR pod, the 91-120 and 120+ buckets grow week over week. Each balance ages out of the appeal window and into write-off territory.
No payer call cadence
Each payer has its own follow-up rhythm. Medicare 14 days. Medicaid 21 days. MA plans 7 to 14 days. Generic billers do not run the cadence. Claims sit.
DSO trending wrong direction
Days Sales Outstanding above 50 days signals a follow-up gap. MGMA 2024 best-in-class SNF DSO sits at 32 to 38 days. Most facilities run 55 plus.
Tell us about your agency.
Send us your situation and our team will scope the right setup, usually within one business day. No obligation.
What is AR aging follow-up for SNF and LTC ?
AR aging follow-up is the daily work of moving open balances out of the aging buckets and into cash. It starts with an aging report split into 0-30, 31-60, 61-90, 91-120, and 120+ day buckets. Each bucket gets a payer-specific cadence: Medicare claims followed up on day 14, Medicaid on day 21, Medicare Advantage on day 7 to 14 depending on contract, commercial on day 21 to 30. The follow-up specialist runs 276 claim status inquiries through the clearinghouse, reviews 277 status responses, and calls the payer directly when the electronic response indicates a problem the system cannot resolve.
What your AR follow-up team handles, day to day
Eight production tasks every aging bucket touches before a claim moves to paid or written off.
Bucket-level worklists
0-30 monitor. 31-60 first follow-up. 61-90 second follow-up. 91-120 escalation. 120+ appeal or write-off decision.
276 claim status inquiries
Electronic 276 inquiries to the clearinghouse for every claim aging past payer cadence. Batch and individual.
277 status response review
Reads 277 responses. Maps status codes to next action. Pending payer = wait. In process = follow-up next cycle. Rejected = rework.
Payer outbound calls
Calls Medicare contractors, state Medicaid plans, MA plans, and commercial payers. Logs call reference numbers in the patient ledger.
Root-cause categorization
Tags every aged claim: pending payer, missing documentation, denial, secondary not billed, eligibility, patient responsibility.
Escalation matrix
Day 14 specialist. Day 30 supervisor. Day 60 manager. Day 90 director. Day 120 write-off authority sign-off.
Write-off vs appeal decision
At 120 days, decision matrix triggers: cost-to-collect, payer appeal window remaining, claim dollar amount. Documented sign-off.
AR KPI reporting
Daily AR over 90, weekly DSO, monthly net collection. Aging movement by bucket. Cash collected versus billed.
Post-acute AR trained, not generic collections
Most outsourcing firms treat AR as a call center. We do not. Our AR follow-up specialists are post-acute trained, payer-cadence drilled, and 276/277 transaction fluent before they ever touch your aging report.
Payer cadence drilled
Every specialist learns the cadence per payer: Medicare 14 days, Medicaid 21 days, MA plans 7 to 14, commercial 21 to 30. The aging worklist runs on cadence, not on inertia.
Stacked compliance posture
HIPAA + SOC 2 Type II + ISO 27001 + HITRUST. Plus alignment with 42 CFR 424 and 45 CFR 164.514. All four certificates available on request.
2-Week Risk-Free Pilot
Industry offers no trial. We give you 14 days of live AR follow-up at the same rate. Cancel before day 14, owe nothing. No annual contracts after.
Staffingly vs DIY in-house vs generic offshore
The real cost math for a single full-time AR follow-up specialist at a mid-size SNF or LTC operator.
From "let's talk" to bucket work in 1 to 2 weeks
Six steps. Each one is documented.
Discovery call (15 min)
Share your current AR over 90 percentage, DSO, and your aging report by payer. We map the worst bucket first.
BAA + access
BAA signed. Role-based access to your EMR billing module and clearinghouse 276/277 portal.
Cadence calibration (2 to 3 days)
Payer cadence locked. Escalation matrix configured. Write-off authority thresholds documented.
Parallel AR work starts
Week 2 to 3. AR specialist works the 61-90 bucket first. Daily 15-minute sync. Cash collected and bucket movement reported.
Decision point (end of week 2)
AR over 90 movement, DSO change, cash collected. Go or no-go. No penalty if you cancel.
Full handoff, cadence locked
Weekly KPI review. Monthly write-off committee. Quarterly DSO benchmark comparison.
How your AR follow-up specialist's day actually looks
A real shift, hour by hour. Coverage rotates so your aging queue is never dark during business hours.
How Staffingly works, in practice
Inside the workA trained Staffingly specialist works inside your existing platform, with clear escalation back to your team.
One Flat Weekly Rate. No Surprises.
Dedicated senior care schedulers at a fixed weekly cost. Per scheduler FTE, per week. No contracts, no minimums, no hidden fees.
Want to compare against an in-house hire? Use the savings calculator.
Frequently asked questions
What are the target percentages for each aging bucket?
MGMA 2024 best-in-class SNF benchmarks place 0-30 at 50 to 60 percent, 31-60 at 15 to 20 percent, 61-90 at 8 to 12 percent, 91-120 at 4 to 6 percent, and 120+ below 10 percent of total AR. AR over 90 in aggregate should stay below 18 percent.
What are 276 and 277 transactions and how do you use them?
The 276 is the HIPAA electronic claim status inquiry. The 277 is the payer response. Under ASC X12 5010, our AR specialists batch 276 inquiries for every claim aged past payer cadence and map the 277 status code to a next-step worklist.
How often should we follow up with each payer?
Medicare on day 14, Medicaid on day 21, Medicare Advantage on day 7 to 14 depending on contract, commercial on day 21 to 30. Patient self-pay on day 30, 60, 90. We run the cadence inside the EMR aging worklist.
What DSO benchmark should we target?
Best-in-class SNF DSO sits at 32 to 38 days per MGMA 2024 benchmarks. Most facilities run 50 to 65 days without dedicated AR follow-up. Each 5-day DSO reduction releases working capital.
Who has write-off authority and at what dollar threshold?
Typical thresholds: AR specialist recommends below $250, supervisor approves up to $1,000, manager up to $5,000, director up to $25,000, CFO above. Every write-off is documented with root cause and tracked monthly for QAPI.
What does the escalation matrix look like?
Day 14 first follow-up. Day 30 second follow-up plus 276 inquiry. Day 45 third follow-up plus payer call. Day 60 supervisor review. Day 90 manager packet. Day 120 director write-off versus appeal decision.
How does pricing work across multiple AR specialists and facilities?
Per AR follow-up specialist FTE per week. No setup fees. $399 Standard, $349 Volume (3 or more), $299 Enterprise (10 or more). No annual contracts.
What is included in the 2-Week Risk-Free Pilot?
Two weeks of live AR follow-up running parallel with your business office on your worst bucket. Daily KPI reporting on AR over 90 movement, DSO change, cash collected, and bucket transitions. No penalty if you cancel before day 14.
President and CEO, Staffingly, Inc. 25+ years in IT consulting and healthcare BPO operations. One of the earliest US operators to set up an RPO/BPO delivery network in India. Leads AI-driven home care workflows that help agencies, home health providers, and multi-branch operators cut admin cost without compromising care.
