Denial Management
Structured triage by root cause, timely appeals, and payer-specific resubmission paths to recover otherwise lost dollars.
Accounts Receivable (AR) Management Services
Get ConnectedWhat Are Accounts Receivable (AR) Management Services?
AR management is the disciplined follow-through after claims leave your PM system—tracking payer responses, working denials, posting payments accurately, and collecting patient balances without damaging relationships.
Done well, it shortens days in AR, reduces write-offs, and gives leadership a clear picture of cash you can count on versus dollars still at risk.
Accounts Receivable (AR) Management Services
Six focused workstreams that keep revenue moving—from first denial touch to patient-friendly statements and accounting tie-outs.
Insurance Follow-Up & Claims Investigation
Portal checks, call strategies, and documentation hunts that resolve “pending” and no-response claims before they age out.
Appeals Management
Level-appropriate appeals with clinical and coding support so overturn rates improve without burning your internal team.
Patient Statement Management
Clear, compliant statements and payment plans aligned with your financial policy and card-on-file workflows.
Patient Support & Follow-Up Calls
Empathetic outreach for balances, EOB questions, and payment options—logged for compliance and QA.
Medical Billing Accounting Support
Payment posting reconciliation, contractual adjustments, and month-end bridges to your ledger or outsourced accounting partner.
Steps in AR Management
A repeatable operating rhythm—so nothing sits in a queue without an owner, a date, and a next action.
Rapid reports
Daily and weekly aging snapshots with payer and CPT rollups leadership can act on.
Account registration
Clean tie between patient, policy, and guarantor so follow-up targets the right responsible party.
Clear timelines
SLA-based touches for 30/60/90 buckets—no “we’ll get to it later” drift.
Positive trends
Tracking recovery rates, denial categories, and collector productivity over time.
Precise actions
Every touch logged: call reference, portal ticket, fax confirmation, or appeal ID.
Adjustments & credits
Contractual posting, takebacks, and credit-balance resolution without duplicate billing risk.
Healthcare Accounts Receivable Benchmarks
Benchmarks vary by specialty and payer mix, but strong programs typically show improving clean-claim rates, stable or shrinking AR days, and denial categories that shrink quarter over quarter—not because denials disappeared, but because you’re fixing upstream causes.
- Net collection rate trending toward specialty norms after contract and bad-debt carve-outs
- A/R over 90 days held below agreed thresholds with escalation when payers stall
- Denial overturn rate tracked by reason code—not just “worked” volume
Key Medical Accounts Receivable (AR) Terms
- Days in AR — Average time from service to payment; specialty and payer mix heavily influence targets.
- Clean claim rate — Share of claims accepted on first submission without edits; upstream of AR health.
- Denial rate / overturn rate — Volume of denials versus successfully appealed or corrected claims.
- Contractual adjustment — Difference between charge and allowed amount per payer contract; not the same as a write-off.
- Credit balance — Overpayment or duplicate posting that must be resolved compliantly—often regulated timelines apply.
- Bad debt — Amount moved to uncollectible after policy-driven collection efforts; should be a small, audited slice of total AR.
How we move a claim from open balance to resolution
Identify
Investigate
Appeal / correct
Post & reconcile
Patient balance