Most practices have real money sitting in aged denied claims and underpaid accounts their current biller has stopped working. We recover it systematically, and we only take on claims that are actually recoverable.
Our Recovery Process
We don't just "work" aged AR; we triage it, prioritise by recovery probability and deadline urgency, and attack systematically.
We pull your complete AR aging report and categorise every claim by payer, denial reason code (CARC/RARC), age, and recovery probability. This takes 48 hours.
Claims approaching payer timely filing limits are escalated to the top of the queue, filed same day. A missed timely filing deadline is an unrecoverable write-off.
Medical necessity appeals require supporting clinical documentation. We work directly with your clinical team to pull records and build airtight appeal packages.
High-value medical necessity denials are escalated to payer peer-to-peer review, a physician-to-physician conversation that is often the fastest route to overturning a clinical denial.
We compare every adjudicated claim against your contracted fee schedule. Underpayments below contracted rates are identified and disputed, an often-overlooked revenue source.
Every recovered dollar comes with an explanation of why it was denied in the first place, so your forward billing workflow prevents the same leaks from recurring.
What We Recover
Different denial types require different recovery strategies. Our team uses the right approach for each, not a one-size-fits-all resubmission.
| Denial Type | CARC Codes | Recovery Strategy | Typical Recovery Range* |
|---|---|---|---|
| Prior Authorization | 15, 197 | Retroactive auth request + clinical documentation package | 30–50% |
| Medical Necessity | 50, 167, 29 | Peer-to-peer review + complete clinical support documentation | 40–60% |
| Timely Filing | 29 | Proof of timely filing documentation (clearinghouse logs, payer receipts) | 10–30% |
| Coding / Bundling | 4, 97, B15 | Corrected claim submission with modifier and documentation support | 70–90% |
| Eligibility / Coverage | 27, 31, 96 | COB investigation, retroactive enrollment verification, secondary billing | 40–60% |
| Underpayments | N/A | Fee schedule audit + formal underpayment dispute with contract reference | 50–70% |
| Duplicate Denial | 18 | Proof of original claim + resubmission with distinct service documentation | Often already paid |
*Planning ranges based on industry appeal and recovery norms. Actual results depend on payer, denial reason and documentation, and are never guaranteed.
For qualified practices, we can structure aged A/R recovery on a contingency basis: our fee is a percentage of what we actually collect on the aged claims. Eligibility depends on balance size, payer mix and claim age, and the terms are confirmed in writing before any work starts. Ask about it in your free AR audit.
Every unpaid claim has a clock on it. Industry data puts the odds of collecting an account unpaid past 120 days at under 30%, and write-off rates for 120+ day balances commonly run 40% to 60%. The claims you can still win are the ones you reach early, which is why triage by deadline and dollar value comes before any appeal gets written.
Appeals are worth the effort when they're done right. Industry studies put the share of appealed denials that get overturned somewhere between 40% and 60%, yet roughly two-thirds of denied claims are never appealed at all. The gap between those two numbers is where recovery work lives. Initial denials are also rising: Experian Health State of Claims 2025 reports 11.8% for 2024.
Denials aren't the only source. Underpayments (a payer paying below the contracted rate) and incorrect write-offs sit in the same aging report, and they carry appeal windows of their own. We look at all three together, because a balance that looks uncollectable is sometimes just an unpaid contract rate.
Written-off balances get a second look too. Adjustments coded as "contractual" that were really denials or short-pays are worth re-checking while the payer's window is still open.
For qualified practices, recovery can run on a contingency basis: our fee is a percentage of what we collect on the aged claims. Eligibility depends on the balance, payer mix and claim age, and we confirm the terms in writing after your free A/R audit.
If you're already a billing client, ongoing A/R follow-up is part of your plan at the percentage-of-collections rate on our pricing page.
It depends on the payer's filing and appeal limits, not just the calendar. Some claims over 180 days are still recoverable, and some at 90 days have already lapsed. We check each claim against the payer's actual deadline.
Yes. Most of our recovery work is exactly that: claims a prior biller or an in-house team stopped working.
Your aging report, remittance data and, for clinical denials, the supporting medical records. We tell you exactly which ones before we request anything.
No. We work from your reports and records, and coordinate with whoever handles your current claims.
Related: Denial management · Payer contracting · How to reduce days in A/R · Free revenue assessment.
Our free AR audit takes 48 hours. We pull your aging report, categorise every recoverable claim, and give you a recovery estimate, before you commit to anything.
Related: Solutions for slow A/R collections.