Denials & A/R recovery
Unpaid deservesan explanation.
Bring disciplined follow-up to denied claims and aging balances. Prioritize work using deadlines, balance, payer response, and the information available.
Discuss this supportRecovery depends on coverage, documentation, payer policy, deadlines, and prior handling. Some balances are not recoverable; that assessment should be explicit.
The work we take on
- 01
Segment open balances and distinguish denials from no-response and other unpaid claims.
- 02
Review remittance reasons, claim history, policy, and supporting documentation.
- 03
Prepare the appropriate correction, reconsideration, or appeal and track follow-up.
What stays with your practice
Your practice approves appeals requiring clinical input, supplies missing records, and controls settlement, write-off, and patient collection policies.
The information
and access we need.
Detailed aging, original claims, remittances, payer correspondence, relevant contracts, supporting records, and authorized portals.
Quality is part
of the work.
Review reason selection, supporting evidence, filing requirements, and follow-up notes. Check that corrected claims and appeals use the appropriate payer process.
A view of progress.
A route for decisions.
A prioritized inventory shows the next action, responsible person, deadline, and unresolved dependency. Monthly reviews connect denial causes to prevention work.
MEASUREMENT WITH CONTEXT
Know what’s moving.
Know what needs attention.
Agree definitions, reporting periods, and the opening baseline before interpreting a result. A measure should lead to a useful decision.
Open the sample monthly review- 01A/R over 90 days, by balance and payer
- 02Initial denial rate and recurring reasons
- 03Appeal outcomes for closed cases
- 04Follow-up completion against agreed priorities
A DENIAL, STEP BY STEP
Follow the exception.
See the work behind a resolution.
Fictional claim VR-2076. This outcome is illustrative, not a reimbursement promise.
Read the payer response
The claim was accepted, then adjudicated with a denial indicating missing authorization. The specialist reviews the complete remittance, not just the headline code.
Specialist’s next action
Confirm the reason, affected service, appeal rights, and applicable deadline.
A clearer next step
Let’s definethe work that matters.
Start with your current denials & a/r recovery workflow, its pressure points, and the support your team needs.
Discuss your revenue cycleA focused conversation. A scope that fits.