Why 60-180 Day Claims Need Special Attention

In revenue cycle management, we call the 60-180 day window the "Death Zone" for good reason. It's where claims go to die—not because they can't be recovered, but because they're often forgotten or deprioritized.

Understanding the Claim Lifecycle

During the first 0-30 days, claims are actively being processed. Your billing team is engaged, follow-ups are happening, and issues are being addressed quickly.

At 31-60 days, warning signs emerge. Claims that should have been paid are showing resistance. Some require additional documentation or appeals.

After 60 days, claims enter the Death Zone. By this point, most billing teams have moved on to newer claims. The bandwidth simply isn't there to give these aged claims the attention they need.

Why Internal Teams Struggle With Aged A/R

It's not that your billing team is incompetent—it's a resource allocation problem:

• New claims take priority: Fresh claims have time-sensitive deadlines
• Aged claims require more time: Each one needs investigation, calls, and documentation review
• The math doesn't work: Spending 2 hours on a $150 claim isn't efficient when there are 50 new claims to process
• Morale impact: Working the same difficult claims repeatedly is demoralizing

The Economics of Aged A/R

Consider a typical 3-clinician behavioral health practice:

• 200 sessions per month
• $115 average reimbursement
• 17% denial/aging rate
• = $3,910 at-risk monthly

At industry-standard 60% recovery rates for specialized A/R teams, that's $2,346 in recoverable revenue per month—or over $28,000 annually that many practices simply write off.

What Makes Specialized Recovery Different

Dedicated A/R recovery teams succeed where internal teams struggle because:

• 100% focus: They only work aged claims—no competing priorities
• Deep payer expertise: They know each payer's quirks and escalation paths
• Volume economics: They can justify spending time on each claim because it's their core function
• Fresh perspective: They approach each claim without the fatigue of having worked it before

Takeaway

The 60-180 day window is where revenue goes to die—but it doesn't have to. With specialized attention, a significant portion of these "lost" claims can be recovered, turning write-offs into revenue.