Most mental-health practices have an aging report. Almost nobody looks at it. Here's why — and the version that actually changed how we run RSLNT.
Why the aging report rots
Three reasons we kept seeing across every practice we talked to before building Heepsters Practice.
- It's stale. The report is generated weekly at best. By the time you look at it, the urgent thing has already gotten worse.
- It's overwhelming. 47 columns, every CPT code, every payer. Nobody knows where to start.
- It has no rule attached. There's no 'if X, then do Y.' It's just a screenshot of pain.
The version we use
Three columns. One rule. One automation. That's it.
Three columns:
- Days outstanding (0–30 / 31–60 / 61–90 / 90+)
- Reason category (eligibility, missing info, denial, paid-but-unposted, statement-aging)
- Owner (front desk, billing, clinician, patient)
That's the report. No payer breakdown — that's a different report we look at quarterly. No CPT code split — also quarterly. Weekly is the survival kit, not the audit.
One rule:
Until that rule landed, 90+ aged out forever. After it landed, 90+ shrank from 18% of A/R to 4% in 90 days.
One automation:
An automation pages me on Slack if total 90+ A/R crosses 5% of the trailing 30-day revenue. I have to acknowledge or assign within an hour.
It's pinged me four times in the last year. Each time it was a real problem we caught a week earlier than we would have otherwise.
How to set this up in your practice this week
- Pick three columns. Resist adding more.
- Set one threshold + one rule. (Ours: 90+ has an owner by noon Tuesday.)
- Wire one automation that interrupts you when it crosses a real line.
- Keep the audit-style monster report — but only look at it quarterly.
The point isn't perfect billing. It's perfect attention. Three columns you'll actually scan beats 47 columns you won't.