Accounts Receivable (AR)
Our Accounts Receivable service focuses on managing the full lifecycle of unpaid insurance claims — actively following up, resolving rejections, and ensuring no revenue is left uncollected.
What We Do for Your Practice
- We actively follow up on claims every 10 to 15 days to ensure they are received and processed by the payer on time
- We perform weekly follow-ups on all outstanding claims to minimize delays in insurance payments
- We identify and minimize EDI and payer rejections by resolving submission errors before resending claims
- We take timely action on denials by fixing issues and resubmitting corrected claims
- We handle reconsiderations and appeals with proper documentation to recover denied or underpaid claims
- We maintain detailed AR aging reports and follow-up logs to track claim status and ensure no revenue is left uncollected
- ✓0–30 Days: Priority review & confirmation
- ✓31–60 Days: Active follow-up & status checks
- ✓61–90 Days: Escalation & resubmission
- ✓90+ Days: Appeals & last-resort recovery
How We Manage Each Aging Bucket
Different aging buckets require different strategies. Our AR team applies the right approach at each stage — from gentle confirmation to aggressive recovery — to maximize collections at every level.
Claims in this bucket are newly submitted. Our priority is to confirm receipt by the payer, verify they are processing correctly, and catch any early rejections or edits before they age further.
Priority Confirmation- Confirm claim receipt via clearinghouse acknowledgement
- Verify claim is in payer's processing queue
- Catch and correct any immediate rejections or edits
- Confirm prior authorization is linked if required
- Monitor ERA/EOB for early payment or denial
- Flag any claims not acknowledged within 5 business days
Claims in this range should have been adjudicated. If not paid, our team calls payers directly, checks claim status, and identifies any holds, pends, or additional information requests that are delaying payment.
Active Follow-Up- Direct payer call to verify claim status
- Identify any pends, holds, or medical review requests
- Submit any requested additional documentation
- Verify patient eligibility was active at date of service
- Confirm correct payer received the claim
- Escalate if payer cannot locate the claim
Claims here are significantly delayed. We escalate our follow-up efforts — checking for systemic payer issues, resubmitting if appropriate, and initiating the formal appeals process for denied claims.
Escalation Required- Escalate to payer supervisor if standard follow-up fails
- Resubmit corrected claim if original had errors
- Initiate formal denial appeal with documentation
- Check for timely filing deadline and act accordingly
- Verify secondary insurance if primary has denied
- Document all call notes and payer responses for audit
Claims over 90 days require aggressive recovery action. We pursue every available option — external appeals, state insurance commission complaints, and write-off analysis — to recover maximum revenue before any claim is closed.
Aggressive Recovery- External independent review organization (IRO) appeals
- State insurance department complaint filing if applicable
- Coordination with practice attorney if warranted
- Patient responsibility transfer and billing if appropriate
- Write-off analysis with management approval workflow
- Root cause documentation to prevent future recurrence
Our AR Management Process
A structured, proactive workflow that ensures every claim is tracked, every follow-up is made on time, and every dollar owed to your practice is pursued.
Each week we pull a complete AR aging report and categorise all outstanding claims by payer, age, and dollar value. High-value and high-risk claims are prioritised to ensure the biggest recovery opportunities are addressed first.
Every outstanding claim is followed up within 10–15 days of submission — via payer portals, automated clearinghouse status checks, or direct payer calls. We document every interaction and update claim status in real time.
Rejected claims are corrected immediately — whether the issue is a demographic error, missing modifier, wrong payer ID, or expired authorisation. Corrected claims are resubmitted the same day the rejection is identified.
Denied claims are immediately routed to our denial management team for root cause analysis and appeal. Underpayments are identified against contracted rates and disputed with payers — recovering revenue that would otherwise be silently lost.
Weekly and monthly AR reports give you complete visibility — collection rates by payer, aging bucket breakdown, denial trends, and recovery performance. These insights allow us to continuously refine our AR strategy and improve your financial outcomes.
Why AR Management Matters
Every day a claim sits unpaid in your AR is a day your cash flow is impacted. Proactive AR management is the difference between a practice that struggles and one that thrives.
Systematic follow-up ensures every claim is pursued to resolution — recovering revenue that would otherwise be written off as uncollectable.
Regular 10–15 day follow-ups keep claims moving through payer systems quickly — reducing days outstanding and keeping your cash flow healthy and predictable.
Our structured AR management reduces your average days outstanding by up to 60% — meaning you collect the same revenue in significantly less time.
Detailed aging reports and performance dashboards give you complete, real-time visibility into what you're owed, who owes it, and when it's expected to be paid.
We actively monitor all payer timely filing deadlines — ensuring no claim is ever lost simply because it wasn't followed up within the payer's required window.