Most dental practices should aim for 30 to 40 days in accounts receivable. That means on average, you’re collecting payment within a month to six weeks of providing treatment. If your days in AR creeps above 45 or 50, you’re carrying too much uncollected revenue and it’s affecting your cash flow.

The aging breakdown matters as much as the total. A healthy AR looks like 75% or more in the 0-30 day bucket, 15% in 30-60 days, and less than 10% over 60 days. When you see more than 15% of your AR sitting beyond 90 days, you’re looking at money that’s increasingly unlikely to get collected. At that point, write-offs become almost inevitable.

Insurance and patient AR behave differently. Insurance claims should resolve within 30 days in most cases. If they’re dragging past that, you likely have claim denials or coding issues that need attention. Patient balances after insurance often take longer because they require statements and follow-up. The patient portion typically needs more active collection effort than the insurance side.

Your collection rate tells part of the story too. Medical and dental practices should aim for 95% or higher on insurance and at least 90% on patient balances. If you’re below those numbers, the issue might be write-offs, missed billing, or accounts going to collections. Track your collection rate separately from your AR days to get the full picture.

High AR usually traces back to a few root causes. Claims not submitted promptly. Insurance denials not worked quickly. Patient statements not going out on time. No systematic follow-up on aging balances. These are process problems, not insurance problems or patient problems. Fix the process and the numbers improve.

The cash flow impact of carrying excess AR is real. A practice doing $80,000 per month with 60 days in AR has $160,000 sitting uncollected at any given time. Drop that to 35 days and you free up $50,000 in working capital. That’s money you can use for equipment, staff, or simply not stressing about payroll every two weeks.

If you’re not tracking these metrics monthly, you’re flying blind. Most practice management software can generate aging reports and collection statistics. The hard part isn’t pulling the report. It’s having someone review it and act on what it shows. An experienced bookkeeper reviewing your AR aging weekly can often identify patterns and problem accounts before they become write-offs.