Money you have already earned, still sitting with the payer
Ageing accounts receivable is rarely a collection problem. It is an attention problem: claims submitted, not paid, and never picked up again. The recoverable money is usually in the oldest buckets, which is exactly where nobody has been looking.
Who this is for
Is this you?
- Practices with a growing A/R balance beyond ninety days and no systematic follow-up process
- Groups changing billing arrangements and carrying legacy A/R that needs working out
- Emergency and urgent care groups whose claim volume outpaces their follow-up capacity
- Practices that can report an A/R total but not what is inside it or why
The problem
What this is actually solving
Claims are worked once and abandoned
A claim submitted, denied or ignored, and touched once more is functionally abandoned. Most ageing A/R is not disputed or uncollectable. It is simply unattended, and it stays that way because nothing routes it back to anybody.
Follow-up follows convenience, not value
Where A/R is worked without a defined order, the small easy claims get worked and the large complex ones age. That feels productive and moves the claim count while the balance barely changes, which is why activity metrics mislead here.
Payer contact history is not kept
Without a documented record of who was spoken to, when, what reference number was given and what they committed to, every follow-up call restarts the conversation. Payers are not incentivised to remember it for you, and a claim with no history is a claim with no leverage.
Scope
What's included
- A/R aging analysis broken down by bucket, payer and claim value
- Systematic follow-up worked oldest-and-largest first rather than by convenience
- Documented payer contact history including reference numbers and commitments
- Claim status verification and re-submission where a payer has no record
- Escalation where a payer misses a stated commitment
- Timely-filing triage so effort goes where recovery is still possible
- Identification of out-of-network underpayments for the dispute process
- Monthly reporting on what moved between buckets and what did not
Scope & engagement model
Where this service ends and another begins. Stating it plainly keeps engagements clean and means every positive claim on this page is one you can hold us to.
- Patient balance collections and statements, which are a separate service line
- Third-party collections agency placement for genuinely bad debt
How we do it
The process
Specific to this service, not a generic four-step onboarding diagram reused across every page.
- Step 01
Analyse before working
The aging is broken down by bucket, payer and value first, because the shape of the problem determines the approach. A balance concentrated in one payer at ninety days is a different job from one spread thinly across everybody.
- Step 02
Triage against the clock
Claims past or close to timely-filing limits are identified before effort is spent. Some of an old balance is already closed, and knowing which part is the difference between recovery work and busywork.
- Step 03
Work oldest and largest first
Follow-up runs by value and age rather than by ease, because that is where the balance actually is. It produces slower claim-count movement and faster balance movement, which is the metric that matters.
- Step 04
Document every contact
Each payer interaction is recorded with date, representative, reference number and any commitment made, so escalation has something to stand on and the next person does not start from zero.
- Step 05
Report movement, not activity
Monthly reporting shows what moved between aging buckets, what was recovered, and what remains stuck with the reason. Claims-touched counts are not a measure of anything.
A denial arrives and is classified by CARC and RARC code and by payer. It then splits into four routes. Front-office data causes go back as a process fix, because appealing them one by one never stops them arriving. Coding causes are corrected against the documentation and resubmitted. Payer policy denials get a written appeal with the record attached, and are the only category worth appealing claim by claim. Out-of-network underpayments leave the denial stream entirely and go to negotiation and then the federal dispute process.
Outcomes
What changes for your practice
- Ageing A/R becomes a worked inventory with a defined order rather than a growing total
- Effort concentrates where recovery is still possible and still worth having
- Documented payer contact history gives escalation something to stand on
- Monthly reporting shows balance movement rather than activity counts
FAQ
Questions we get asked
How far back is old A/R still worth working?
It depends on payer timely-filing limits and on what happened to the claim, which is why triage comes first. Some old balances are genuinely closed and working them is wasted effort. The free billing audit looks at aging specifically to answer this before either side commits.
Do you handle patient balances too?
Patient billing and statements are a separate service line. This covers insurance A/R, following up with payers on submitted claims that have not been fully paid. Many practices want both and they are commonly bundled, but they are scoped separately because the work is genuinely different.
What happens if a payer simply will not pay?
That depends on why. A payer refusing on policy grounds is an appeal. A payer underpaying an out-of-network claim is a negotiation and potentially a dispute, which is a different process with different deadlines. A payer with no record of the claim is a resubmission. The reason determines the route, which is why classification comes before action.
Compliance
- HIPAA-compliant processes across every engagement
- Our team has completed HIPAA training
Related
Related services
Denial Management & Appeals
Denials classified by CARC code and cause, then fixed at source or appealed on the record.
About Denial Management & AppealsIDR Services
Qualification, open negotiation, offer preparation and submission through federal Independent Dispute Resolution.
About IDR ServicesEnd-to-End Revenue Cycle Management
Every service we offer, run as one engagement, from registration through to disputes.
About End-to-End Revenue Cycle ManagementER Billing Services
Emergency department revenue cycle: high volume, high out-of-network exposure, unpredictable payer mix.
About ER Billing Services
Start with a free billing audit
We review a sample of your recent claims and your current A/R aging, and report where revenue is being lost. The report is yours whether or not you engage us.