Accounts Receivable Aging Analysis

The question

I pull this from the live Curve Hero aging dashboard — not from a school dataset. Practice-management systems know the claim. The front office still needs a page that splits insurance A/R vs patient A/R, ages the open balance, and names the 90-day pile first.

Who do we work first, and is this money the payer’s or the patient’s?

Context, not a collections claim

Posted collections were higher in 2025 than 2024. Production went up; insurance stayed about 64% of collections both years and cards stayed in the low-thirties. I am not publishing the practice’s annual dollar mix by card type, and I am not saying the Excel A/R tracker caused the collections lift. The number I own is the 90+ share of open A/R.

Aging: two snapshots, same board

Default aging dashboard in Curve. Totals as shares only on this page — no patient names.

Nov 16, 2025

Patient A/R	71% of open
Insurance A/R	29% of open
90+ share	31.4%

Later snapshot

Patient A/R	66% of open
Insurance A/R	34% of open
90+ share	18.7%

Open A/R barely moved. The mix did. 90+ fell from 31.4% to 18.7% on a later Curve pull. Patient average owing over 90 days went from $192 to $153. Those two pulls are the documented figures. I am not adding a third extract or rounding down to 14%.

Nov 16 aging mix of open A/R (90+ taken from the pie; other buckets scaled from the bar chart so they sum to 100%):

0–30

~41%

31–60

~19%

61–90

~8%

90+

31.4%

Nov 16, 2025 · share of open A/R

90+ share · two looks

31.4% Nov 16

18.7% Later

31.4% → 18.7% · no third extract

The stacked insurance/patient bars tell the same story both days: 0–30 is mostly insurance (ERA still in flight). 90+ is mostly patient (statements, plans, collections review). Working “total A/R” as one pile would send the morning to the wrong phone.

What the Excel A/R tracker holds

Curve is the source of truth. The workbook is the morning follow-up list: placeholder IDs (RP-100x / P-20xx), not PMS IDs; aging buckets; a follow-up queue. Most recent visit and next appointment on the public file are demo dates so the morning follow-up list is visible without scheduling PHI. Dollar aging is from a 23 Sep 2026 90+ outstanding extract — labeled as 90+ only, not the full open board in the case study.

Ledger — Responsible Party Patient ID, Patient ID, visit dates, patient vs insurance aging. Some responsible parties cover 2–3 patients.
Calcs / Aging pivot — live SUMIFS: mix, 90+ share, accounts with no next appointment.
Aging pivot — live SUMIFS tables plus a pie: scheduled for next appointment vs not.

Download A/R tracker De-identified sample. IDs only. No names.

Daily workflow

Open the aging board. If 90+ is a third of open A/R, that is the first hour — not new production.
Insurance A/R means payer calls, ERAs, denials, appeals. Patient A/R means statements, plans, collections review.
Work the follow-up queue. When you touch a claim, set a new next-follow-up date so the count is honest tomorrow.
When money posts, enter the payment. Balance hits $0 and aging goes to —.

Never type over

Balance	Charge − ins paid − pat paid − adj
Age	Today − date billed
Bucket	0–30 / 31–60 / 61–90 / 90+
Needs FU	Open $ and follow-up ≤ today

Status language

Pending insurance	Waiting on ERA / EOB
Denied	Correct/resubmit or appeal
Patient billed	Payer done; patient owes
Collections review	90+ patient $ still open

Limitations

Practice is unnamed here (a Denver-area dental practice). No patient names, no chart copies from the PMS, no provider names, no annual collections mix by card type. The Nov 16, 2025 snapshot is dated in Curve (31.4% in 90+); the second aging screenshot is the same dashboard on a later pull (18.7% in 90+). The public workbook is a 90+ outstanding extract with placeholder IDs and demo visit / next-appointment dates — it is not the full open A/R mix those two percentages describe.