--- title: "Cutting 90+ day AR by 62% for a home-care agency" description: "Cutting 90+ day AR by 62% for a home-care agency. What we did, the numbers before and after, and what changed." url: https://ledgerbpo.com/case-studies/home-care-ar-90-days/ updated: 2026-09-11 publisher: LedgerBPO (SS Support Network LLC) language: en-US --- # Cutting 90+ day AR by 62% for a home-care agency Case study · Home care & home health 90+ day AR down 62% A home-care agency in the Midwest billed a mix of Medicaid waiver programs, managed-care plans, long-term care insurance and private-pay families. Claims went out, but nobody owned the follow-up. Denials sat in the clearinghouse, family invoices were sent once and forgotten, and the 90+ day bucket grew every month. The agency engaged LedgerBPO for home-care billing, accounts receivable and AR follow-up calls. A named billing specialist, a backup and a team lead worked inside the agency's scheduling software, clearinghouse and QuickBooks Online. Over the engagement the 90+ day AR balance fell by 62%. The agency did not add staff, change payers or switch software. It added a team whose only job was to bill cleanly and follow every unpaid claim and invoice to a resolution. Updated September 2026 ## Headline result 90+ day AR down 62% As reported by the client after the engagement. Further figures are published only when both before and after values are on file. ## What we did 1. 01 ### Access and setup We signed a business associate agreement and an NDA, then received user accounts with MFA for the agency's scheduling and EVV system, the clearinghouse, payer portals and QuickBooks Online. Bank feeds were read-only. Our HIPAA-trained staff worked on managed devices with no local downloads, and access logs were kept for every login. The agency owner kept sole authority over payments and write-offs. 2. 02 ### Aging clean-up We pulled the full AR aging and worked it oldest first. Every claim over 90 days was traced to a status: paid but unposted, denied and fixable, denied and outside timely filing, or never received by the payer. Fixable denials were corrected and resubmitted. Unposted remittances were applied so the aging stopped showing cash that had already arrived. Balances that could not be recovered were listed for the owner's write-off decision, not written off by us. 3. 03 ### Weekly cadence Visits confirmed in EVV were billed on a fixed weekly schedule so nothing waited for month-end. Each week the team lead reviewed the aging by payer and by bucket, and every claim over 30 days had a next action and a date. Private-pay families received our DunningDesk cadence: statement, reminder, call, and a payment-plan offer where the owner approved it. The month closed under our Two-Tier Review. 4. 04 ### AR follow-up calls under the agency's brand Our BillingLine desk called payers on unpaid claims and called families on open invoices, using the agency's name and scripts the owner approved. Every call, reference number and promise-to-pay was logged. Agents never took card details; families paid through the agency's own portal. Calls followed TCPA and state rules on timing and recording, and the tone stayed first-party and courteous. 5. 05 ### Reporting The owner received a weekly cash and aging snapshot and a monthly pack through our LedgerDesk portal: collections by payer, denial reasons ranked by dollar value, days sales outstanding and the 90+ day balance against its starting point. Denial reasons that pointed back to intake, such as missing authorizations, were passed to the agency's scheduling team so the cause was fixed rather than the symptom. ## Services used - [Every visit billed within 48 hours](https://ledgerbpo.com/services/home-care-billing/) - [Get paid faster with a dedicated AR desk](https://ledgerbpo.com/services/accounts-receivable/) - [A structured call cadence for every aging bucket](https://ledgerbpo.com/services/billing-calls/ar-follow-up-calls/) Next step ## Want the same shape of result? Tell us where the books or billing hurt. A named person replies within 1 business day with a plan for the first 30 days. - Reply from a named person within 1 business day - No setup fee, month-to-month - Your software, your data, no lock-in Start with a custom quote [Get a custom quote](https://ledgerbpo.com/get-a-quote/) [Book a 20-minute call](https://ledgerbpo.com/book-a-call/) Or call [+1-657-777-0006](tel:+16577770006) during US, UK or Australian business hours. --- Source: https://ledgerbpo.com/case-studies/home-care-ar-90-days/ · Contact: https://ledgerbpo.com/contact/ · Full site map for agents: https://ledgerbpo.com/llms.txt