Most practices have between $80,000 and $400,000 sitting in aged denied claims and underpaid accounts their current biller has stopped working. We recover it — systematically, with an 80% success rate on claims we take on.
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 overturns 65%+ of appealed clinical denials.
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 | Avg. Recovery Rate |
|---|---|---|---|
| Prior Authorization | 15, 197 | Retroactive auth request + clinical documentation package | 74% |
| Medical Necessity | 50, 167, 29 | Peer-to-peer review + comprehensive clinical support documentation | 65% |
| Timely Filing | 29 | Proof of timely filing documentation (clearinghouse logs, payer receipts) | 68% |
| Coding / Bundling | 4, 97, B15 | Corrected claim submission with modifier and documentation support | 89% |
| Eligibility / Coverage | 27, 31, 96 | COB investigation, retroactive enrollment verification, secondary billing | 61% |
| Underpayments | N/A | Fee schedule audit + formal underpayment dispute with contract reference | 82% |
| Duplicate Denial | 18 | Proof of original claim + resubmission with distinct service documentation | 94% |
For qualified practices, we offer a contingency-based AR recovery engagement: no recovery, no fee. Our fee is a percentage of what we actually collect from aged claims — so we are financially motivated to maximize your recovery. If we don't collect, you owe us nothing. Ask about contingency eligibility in your free AR audit.
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.