For medical providers working with personal injury cases, there's a familiar frustration: the care has been delivered, the documentation is complete, but payment is still months — sometimes years — away.
It's not that the revenue doesn't exist. It does. It's just not accessible yet.
This gap between care delivery and cash collection is where aging accounts receivable (AR) quietly becomes a problem. And for many providers, it's a bigger problem than they realize.
Below, we answer five of the most common questions we hear from medical providers navigating aging AR in personal injury cases.
In personal injury (PI) cases, payment doesn't come from insurance in the traditional sense. Instead, providers deliver care under a lien agreement, meaning they'll be paid once the case settles—whenever that occurs.
The timeline depends on factors outside the provider's control: legal negotiations, case complexity, court schedules, and insurance disputes. Settlement can take 12 to 18 months on average, and complex cases can stretch well beyond that.
During this time, the provider has already incurred costs — staff, supplies, overhead — but the revenue remains locked in the case.
When AR ages, it doesn't just sit quietly on the balance sheet. It creates a ripple effect across the practice:
According to MGMA, 56% of medical groups reported that their days in AR increased in recent years — a sign that this challenge is becoming more common, not less.
PI receivables accumulate quietly. Each case adds to the balance sheet, but because the revenue is "expected," it often doesn't trigger the same concern as an unpaid invoice from a commercial payer.
Over time, this creates a gap between what the practice has earned and what it can actually access. Many providers don't fully recognize the scale until they need capital for a specific purpose — a new surgery center, an equipment upgrade, a second location — and realize how much is locked up.
A 2024 report from PYMNTS Intelligence found that 84% of healthcare organizations experienced financial losses tied to outdated or inefficient AR processes. The issue isn't that providers are doing something wrong. It's that the system creates delays by design.
This is where many providers feel stuck. The traditional options aren't appealing:
None of these options are ideal. Waiting creates operational strain. Selling at a discount means leaving money on the table. And debt adds risk and repayment obligations.
A better approach is strategic receivables management — working with a partner who can unlock value from aging AR while preserving the full potential of each case. This allows providers to access working capital tied to care they've already delivered, without sacrificing long-term revenue or taking on traditional debt.
This is the model behind MedRec by Golden Pear. Rather than forcing providers to choose between cash flow and case value, MedRec helps practices unlock receivables in a way that supports both.
Yes — and this is a critical distinction.
Unlocking value from AR doesn't mean rushing settlements or interfering with legal strategy. It means recognizing that the value of care already delivered shouldn't be trapped indefinitely.
Providers can work with partners who understand the PI ecosystem — the legal timelines, the lien structures, the reimbursement realities — and who offer solutions designed to work within that system, not around it.
The goal isn't to accelerate outcomes. It's to ensure that the financial side of the practice doesn't fall behind while cases progress at their own pace.
Aging AR is one of the most common — and most underestimated — challenges for medical providers in the PI space.
The revenue exists. The care has been delivered. But when that value sits inaccessible for months or years, it shapes every decision the practice makes.
Understanding how AR works, why it accumulates, and what options exist to manage it is the first step toward operating with more stability and confidence.
If your practice is carrying aging receivables from PI cases and exploring ways to unlock that value, MedRec by Golden Pear may be able to help.