The Power of Patterns: Turning AR Trends into Tactical Wins

In today’s hospital revenue cycle, patterns in accounts receivable (AR) are more than just numbers on a report – they’re signals. They reveal early warning signs, highlight opportunities to strengthen payer relationships, and provide a roadmap for sustainable cash flow. Leaders who learn to spot and act on these patterns can shift from reactive firefighting to proactive, strategic management.

Spotting Early Warning Signs

Every AR leader knows the anxiety of a sudden slowdown in cash. But revenue disruptions rarely appear overnight – they build quietly, accumulating until they become full-blown crises. The organizations that thrive are those that detect the signals early and intervene before problems spiral.

Consider the following red flags:

• A sudden spike in AR aging beyond 90 days for a specific payer or service line
• A 20%+ increase in denials for medical necessity or authorization
• Payment turnaround times stretch well beyond contract terms
• A drop in first-pass resolution rates below 85%
• A spike in small balance write-offs that erode net revenue

Each of these metrics represents an early warning. When caught quickly, they can be managed with minimal disruption. Left unchecked, they threaten both short-term liquidity and long-term financial stability.

Key takeaway: Early detection equals better control of cash flow.

Improving Payer Relationships Through Data

Patterns are not just for internal monitoring – they can also transform payer conversations. Too often, providers approach payers with generalized frustrations: “We’re seeing too many denials.” While true, such statements rarely prompt meaningful action.

Now imagine reframing the discussion with concrete data:

“In the past 60 days, 23% of cardiology claims have been denied for medical necessity, totaling $1.2 million. What steps can we take together to address this trend?”

Data-driven conversations move from complaint to collaboration. They:

• Ground the dialogue in facts, not anecdotes.
• Create accountability by quantifying the financial impact.
• Position providers as proactive partners rather than adversaries.

Reflection point: How is your organization currently presenting denial data to payers – reactively, after the damage is done, or proactively, as an opportunity to prevent future issues?

Turning Insights Into Action

Spotting a trend is only the first step. The true value of patterns lies in the actions they inspire. For example:

• Re-prioritize staff worklists to target the highest-dollar denial categories.
• Adjust front-end workflows, such as registration or authorization, to reduce repeat issues.
• Reallocate resources temporarily to payer-specific backlogs until trends stabilize.
• Deploy automation strategically to give staff more bandwidth for prevention.

Imagine your denial rate for “No Authorization” jumps 20% overnight. The first three changes you make to your workflow will determine whether that spike is a short-term blip or the start of a dangerous pattern.

Key takeaway: Proactive leaders don’t just watch the numbers – they pivot quickly, using data as their compass.

Driving Targeted Action Through Data

Not every issue deserves equal attention. The challenge for AR leaders is separating the signal from the noise. Dashboards, heat maps, and prioritized lists help identify which trends warrant immediate intervention.

A practical framework is to focus on the “big rocks” – the problems with both the highest dollar impact and greatest frequency. Fixing small but high-dollar issues generates faster wins and builds momentum across the team.

Consider these questions:

• If you could only address one denial category this quarter, which would it be?
• How much revenue could you reclaim by tackling that category first?
• How would solving it impact downstream workflows?

Targeting action where it matters most keeps teams focused and results visible.

Empowering Teams for Long-Term Wins

Data loses its power if it only lives on leadership dashboards. Frontline staff must see the same patterns, understand their significance, and feel empowered to act.

Weekly huddles that review denial categories, assigning “category owners” to specific trends, and sharing transparent scorecards can drive ownership. When teams know what matters most – and when their contributions are celebrated – they develop a sense of agency and accountability.

For example, reducing no-auth denials by 10% should be recognized as a win, not just another data point. Recognition builds morale and reinforces the value of data-driven problem-solving.

Ask yourself: Do your frontline staff know which trends matter most, or are they working queues without context?

Empowered teams don’t just resolve today’s denials – they prevent tomorrow’s.

Case-in-Point Scenarios

To make this more tangible, here are a few common “data detective” moments AR leaders face:

Scenario 1: Authorization Denials Spike.

• Authorization denials have increased 58% this month. The payer is the same, but the procedure mix has shifted. The best first step? Review authorization submission processes, as workflow gaps are often the culprit.

Scenario 2: Aging Balances Build.

• Your top three payers each have more than 40% of balances in the 181–365-day bucket. Immediate escalation with payers is essential; these accounts are at risk of timely filing write-offs.

Scenario 3: Dashboard Red Flags.

• Denials are up 15%, cash collections are down 10%, but productivity is steady. The logical place to start? Audit denial trending, as rising denials are directly cutting into cash flow.

Each of these examples demonstrates that trends are not static – they are calls to action.

Conclusion

Organizations can no longer afford to treat denials and AR delays as isolated frustrations. Patterns tell a story. When leaders spot them early, use them to guide payer dialogue, align staff around targeted interventions, and empower teams, they transform patterns into tactical wins.

In the end, trends are the compass – but action is the map that gets you to results.

References

Author Bios

Evan Martin, CRCR, EHRC

Vice President of Revenue Cycle Management, ZoomCare

Evan Martin is Vice President of Revenue Cycle Management at ZoomCare, with extensive experience spanning hospital and professional services. A Six Sigma–trained leader, he has advanced denial prevention, revenue integrity, and process improvement to strengthen financial outcomes. Evan also hosts The Wilshire IT RevCast, highlighting innovations in revenue cycle management, and serves as President of the Oregon Chapter of HFMA.