Billing & AR Management

Medical Billing & Accounts Receivable Management

Turn every claim into collected revenue. Our billing specialists submit clean claims, post payments within 24 hours, and pursue every dollar in your AR until it is collected, written off by policy, or exhausted at appeal.

18-Day Average Days in AR
99% Clean Claim Rate
$500M+ Revenue Recovered

Full-Cycle Billing & AR Solutions

From the moment a charge is captured to the final dollar collected, our billing team manages every step of the claim lifecycle with the precision and persistence that protects your revenue.

Claim Submission

Every claim passes through our multi-point scrubbing engine before submission, checking for coding accuracy, demographic mismatches, payer-specific formatting rules, and NCCI edits. The result: a 99% first-pass acceptance rate that accelerates your cash flow.

Payment Posting

Electronic and manual payment posting within 24 hours of receipt, including ERA/EOB reconciliation, contractual adjustment validation, patient responsibility transfer, and immediate identification of underpayments, zero-pays, and denials for follow-up.

AR Follow-Up

Aggressive, payer-specific AR follow-up on every unpaid claim starting at day 21. Our team contacts payers by phone and portal, tracks claim status, resolves pending issues, and escalates stalled claims through supervisor and provider relations channels.

Underpayment Recovery

Systematic comparison of every payment against contracted fee schedules and allowable rates. When payers underpay, we file formal disputes with supporting documentation, recover the variance, and track payer behavior to identify patterns of systematic underpayment.

Patient Billing

Professional, compliant patient statements with clear balance explanations, online payment portal integration, and payment plan administration. Our patient-friendly billing approach improves collection rates while maintaining the trust your patients expect from your practice.

Collections Management

Compliant early-out and bad-debt collection programs that recover patient balances while protecting your brand. We use a diplomatic, multi-channel approach including statements, calls, texts, and email, escalating to external agencies only when internal efforts are exhausted.

Detailed AR Aging Workflow

Every claim is tracked through a rigorous aging-based workflow with escalating actions at each milestone, ensuring nothing falls through the cracks.

Days 0-20: Submission & Monitoring

Claims are scrubbed, submitted electronically, and monitored for clearinghouse acceptance. Rejected claims are corrected and resubmitted within 24 hours. ERA auto-posting captures early payments and flags exceptions for manual review.

Days 21-45: First-Touch Follow-Up

Unpaid claims receive proactive payer outreach via portal and phone. We verify claim receipt, confirm processing status, resolve any pending requests for additional information, and document every interaction for audit trail compliance.

Days 46-90: Escalated Pursuit

Claims still unpaid are escalated to senior AR specialists who engage payer supervisor lines, file formal grievances, submit corrected claims if needed, and initiate appeal processes for improper denials or underpayments.

Days 90+: Recovery & Resolution

Aged balances receive final-stage intervention including state insurance commissioner complaints, provider relations escalations, and secondary/tertiary payer billing. Uncollectible balances are documented with full work history for write-off approval.

Your AR Is Your Cash Flow Lifeline

Every day a claim sits unpaid, your practice loses money. Industry data shows that the probability of collecting a claim drops by 5% for every 10 days it remains in AR beyond 30 days. At 120 days, collection probability falls below 50%. Our aggressive, systematic approach keeps your AR lean and your cash flow predictable.

  • Average days in AR reduced from 45+ to 24 days
  • AR over 90 days held below 8% of total receivables
  • Net collection rate consistently above 97%
  • $500M+ recovered for healthcare providers nationwide
  • Zero-balance AR clean-up for new client onboarding
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97%+
Net Collection Rate
<8%
AR Over 90 Days
99%
First-Pass Clean Claim Rate
18 Days
Average Days in AR
97%+
Net Collection Rate
$500M+
Total Revenue Recovered

Frequently Asked Questions

Common questions about our medical billing and accounts receivable management services.

Every claim passes through a multi-layer scrubbing process before submission. We validate patient demographics against the eligibility response, confirm coding accuracy with NCCI edits and LCD/NCD crosswalks, check for payer-specific formatting requirements, and verify that all required fields are populated. Claims that fail any check are routed to a specialist for correction before they leave our system. This upfront rigor eliminates the rejections and denials that drag down first-pass rates.
Denied claims are immediately routed to our denial management team, categorized by denial reason code, and assigned a resolution path. For correctable denials (wrong modifier, missing auth number), we correct and resubmit within 24 hours. For clinical denials or medical necessity issues, we prepare and submit formal appeals with supporting documentation within 48 hours. Every denial is also logged in our trending system to identify root causes and prevent recurrence.
Electronic remittance advices (ERAs) are auto-posted within 4 hours of receipt. Manual EOBs and paper checks are posted within 24 hours. Every payment is reconciled against the expected allowable, and variances are flagged for underpayment review. Patient responsibility balances are transferred and statements generated on the same day as insurance payment posting, eliminating delays in the patient billing cycle.
Yes. We offer dedicated AR clean-up projects for new clients with aged balances. Our team performs a full inventory of your outstanding AR, prioritizes claims by age and dollar value, and works through the backlog systematically. Most clients see a 40-60% reduction in AR over 90 days within the first 90 days of engagement. Once the backlog is resolved, we transition to ongoing AR management to keep your receivables current.
We load your contracted fee schedules into our system and automatically compare every payment against the expected allowable. When an underpayment is detected, we file a formal dispute with the payer, including the contracted rate, the payment received, and supporting documentation. We track underpayment patterns by payer and CPT code to identify systematic issues that may warrant contract renegotiation or escalation to your payer relations team.
You receive comprehensive monthly reports covering charges, payments, adjustments, net collection rate, days in AR, AR aging distribution, denial rate and top denial reasons, payer mix, and procedure volume trends. We also provide real-time dashboard access so you can monitor key metrics at any time. Quarterly business reviews with your dedicated account manager dive deeper into trends, opportunities, and strategic recommendations.