Healthcare AR Aging Is Worsening Across the Industry
Accounts receivable aging is one of the most closely watched metrics in healthcare finance, and the trends in 2025 and 2026 are concerning. The Medical Group Management Association (MGMA) reports that the percentage of total AR in the 90-plus day bucket increased to 22.4 percent for physician groups in 2025, up from 18.1 percent in 2022. For hospitals, the Healthcare Financial Management Association (HFMA) notes that median days in accounts receivable reached 56.3 days in 2025 — the highest level since 2016.
Several factors are contributing to this deterioration. Commercial payer processing times have lengthened as insurers implement more complex pre-payment audit programs. Patient cost-sharing has risen with high-deductible health plan enrollment now representing 54 percent of employer-sponsored coverage according to the Kaiser Family Foundation, creating larger patient balance portfolios that are harder and more expensive to collect. And staffing shortages in healthcare billing operations have left many AR departments under-resourced relative to their balances.
Healthcare AR management companies — which handle collections on behalf of providers on an outsourced basis — are under pressure to demonstrate results in this environment. Virtual assistants are emerging as a key part of the operational response.
Payer Follow-Up: The Engine of AR Resolution
Resolving outstanding insurance balances requires persistent follow-up. Claims that have aged beyond 45 days without payment typically require direct phone contact with payer provider services lines, portal-based status inquiries, or written status requests. Each of these interactions takes time, and the follow-up cycle must be repeated at regular intervals until the claim is paid, denied, or escalated.
Virtual assistants are well-suited to managing this follow-up cycle for a defined portfolio of accounts. A trained VA can work an aging report, prioritize follow-up by dollar value and days outstanding, contact payer provider lines during business hours, log call outcomes in the AR management platform, note expected payment dates provided by payers, and flag accounts requiring clinical documentation or appeal support for escalation to a senior AR specialist.
Research from Black Book Market Research indicates that AR management companies that assign dedicated follow-up resources to specific payer segments — rather than routing all follow-up through a general queue — achieve 19 to 25 percent faster resolution on followed accounts. VAs can be assigned to specific payer portfolios, developing familiarity with each payer's processes that improves call efficiency over time.
Payment Posting: Accurate and Timely Application of Remittances
Payment posting is the process of applying payer and patient payments to the correct accounts in the practice management system, reconciling electronic remittance advice (ERA) files, identifying contractual adjustments, and flagging underpayments for review. Accurate and timely payment posting is essential for maintaining a clean AR picture and identifying underpayment patterns that warrant payer contract review.
Payment posting is largely a data-entry and reconciliation function. Virtual assistants trained in ERA processing and practice management system navigation can handle standard payment posting for auto-adjudicated claims, apply patient payments from lockbox or online payment reports, and flag ERA line items with unusual adjustment reason codes for specialist review. This structured division of posting work — VAs handle routine postings, specialists review exceptions — increases total posting throughput without requiring additional credentialed billing staff.
HFMA estimates that manual payment posting costs the average healthcare organization $3.75 per claim in staff time. Routing routine postings to VA support can reduce that per-claim cost meaningfully for high-volume AR management operations.
Client Reporting: Turning AR Data Into Accountable Deliverables
AR management companies provide their provider clients with regular reporting on portfolio performance: total outstanding balance, aging distribution, payer mix, denial rates, collection rates, and resolution timelines. These reports are the primary basis on which clients evaluate the value they are receiving from their AR management partner.
Compiling and formatting these reports is time-consuming administrative work that does not require AR expertise. Virtual assistants can pull aging and collection data from AR management platforms, populate standardized client report templates with current metrics, calculate period-over-period comparisons, and distribute reports to client contacts on scheduled cadences. Account managers are freed to interpret results, present findings in client review calls, and develop improvement recommendations rather than spending hours formatting spreadsheets.
Healthcare AR companies looking to build scalable reporting and follow-up operations can explore trained virtual assistant resources through Stealth Agents, which provides VAs experienced in healthcare administrative and billing support functions.
The Economic Logic of VA Integration in AR Management
The Bureau of Labor Statistics reports median wages for billing and claims specialists at $40,850 in 2025. With benefits and overhead, in-house AR follow-up staff carry fully loaded annual costs of $55,000 to $65,000 in major markets. Virtual assistants providing comparable follow-up and posting support typically cost 40 to 55 percent less on a comparable-hours basis.
For AR management companies that charge clients a percentage of collections, reducing internal costs while maintaining or improving collection rates directly improves firm profitability. The combination of lower cost per follow-up contact and higher throughput per specialist makes VA integration one of the highest-return operational investments available to healthcare AR companies.
AR Management in 2026 and Beyond
As payer complexity grows and patient financial responsibility continues to rise, healthcare AR management companies that can maintain high throughput and consistent reporting without proportional cost increases will be well-positioned in a competitive market. Virtual assistant integration in follow-up, payment posting, and reporting is no longer an experimental tactic — it is becoming a standard component of competitive AR operations.
Sources
- Medical Group Management Association (MGMA) — Accounts Receivable Benchmarking Study 2025
- Healthcare Financial Management Association (HFMA) — Revenue Cycle Key Indicators Report 2025
- Kaiser Family Foundation — Employer Health Benefits Survey 2025
- Black Book Market Research — AR Management Operational Efficiency Survey 2025
- U.S. Bureau of Labor Statistics — Occupational Employment and Wage Statistics 2025