Services / AR Management

Accounts Receivable
Management & Follow-Up Services

Recover unpaid claims and optimize your accounts receivable with expert A/R management that reduces outstanding balances and accelerates cash flow.

60%Increased Collections
40%Reduced A/R Days
$380KAvg Annual Recovery
95%A/R Under 90 Days

What Sets Medages A/R Apart

Daily A/R review and prioritization
Age-based follow-up protocols
Automated underpayment detection
Contract rate verification on every payment
Direct payer relationships and contacts
60% improvement in collection rates

AR Aging Analysis

Visualize collection probability by aging bucket. Every day of delay reduces your likelihood of recovery.

AR Distribution by Aging Bucket

0-30 Days
30%
95%
31-60 Days
25%
85%
61-90 Days
20%
70%
91-120 Days
15%
50%
120+ Days
10%
25%
Bar width = % of total AR | Right value = collection rate
$500,000Total AR
$368,750Expected Collection
73.8%Collection Rate
$131,250Potential Loss
Key Insights
Accounts over 120 days have only a 25% collection probability
Every 30 days of aging significantly reduces collection likelihood
Proactive AR management can recover up to 85% of aging accounts
Best practice: Keep 80%+ of AR under 60 days
Industry benchmark: Healthy practices maintain 60-70% of AR in the 0-30 day bucket.

The Revenue Problems We Fix

Outstanding accounts receivable ties up cash flow and reduces practice profitability. These challenges prevent effective collections.

Aging Accounts Receivable

Outstanding balances continue to age beyond 90 days, reducing the likelihood of collection and negatively impacting cash flow and working capital.

Impact: Accounts over 120 days have less than 25% collection probability

Lack of Follow-Up Systems

Without structured follow-up processes, unpaid claims sit idle while timely filing limits expire and collection opportunities are permanently lost.

Impact: Unworked A/R results in permanent write-offs and revenue loss

Underpayments Go Undetected

Contractual adjustments and payment variances are not systematically reviewed, allowing payers to underpay without detection or correction.

Impact: Hidden revenue loss of 2-5% from unidentified underpayments

Inefficient Collections Process

Manual, time-consuming A/R management processes drain staff resources while delivering poor results and inconsistent outcomes.

Impact: High labor costs with low recovery rates strain operations

Payer Communication Delays

Ineffective payer communication and lack of dedicated follow-up staff result in extended resolution times for outstanding claims.

Impact: Average 60-90 days to resolve claim inquiries delays cash flow

Limited A/R Visibility

Without detailed reporting and analytics, practices cannot identify problems, prioritize efforts, or measure collection performance.

Impact: Unable to focus on high-value accounts or problem payers

What Makes Our Approach Work

Our approach is built on transparency - you see exactly what we are doing, why, and what it produces.

Systematic A/R Follow-Up

  • Daily A/R review and prioritization
  • Age-based follow-up protocols
  • Deadline tracking prevents write-offs
  • 60% improvement in collection rates

Advanced Payment Analysis

  • Automated EOB analysis and variance detection
  • Contract rate verification on every payment
  • Underpayment identification and recovery
  • Detailed payment reconciliation

Expert Payer Communication

  • Direct payer relationships and contacts
  • Strategic escalation when needed
  • Professional persistence without antagonism
  • Resolution time reduced by 50%

Comprehensive A/R Analytics

  • Real-time A/R aging reports
  • Payer-specific performance metrics
  • Collection trending and forecasting
  • Actionable insights for improvement

Everything You Get

Every component managed with precision and expertise.

Outstanding Claim Follow-Up

  • Daily claim status monitoring
  • Payer inquiry and follow-up
  • Documentation requests
  • Escalation procedures

Payment Variance Analysis

  • EOB analysis
  • Contract verification
  • Underpayment recovery
  • Adjustment validation

A/R Reporting and Analytics

  • Aging bucket analysis
  • Payer performance reports
  • Collection trending
  • Custom dashboards

Patient Balance Management

  • Patient statement generation
  • Payment plan setup
  • Courteous follow-up
  • Financial counseling

Proven Results

Our expertise delivers measurable improvements in performance and revenue.

60%Increased Collections
40%Reduced A/R Days
$380KAvg Annual Recovery
95%A/R Under 90 Days

Accelerate Your Cash Flow

Our A/R management team recovers outstanding balances and reduces days in A/R by 40%. See how we can transform your collections.

HIPAA Compliant99% Clean ClaimsNo Setup Fees

The Eventual Benefits for Your Practice

Beyond immediate revenue recovery, our AR management delivers transformational long-term outcomes.

Predictable Cash Flow

Consistent monthly collections replace unpredictable revenue cycles. Know exactly what is coming in, allowing confident business planning, staff expansion, and equipment investments without financial uncertainty.

Freedom to Focus on Patient Care

Your staff stops spending hours on hold with insurance companies and chasing payments. They redirect that time to patient care, appointment scheduling, and practice growth initiatives that truly matter.

Maximized Practice Valuation

Clean A/R with minimal aging significantly increases your practice value. Whether planning for retirement, seeking investment, or positioning for acquisition, strong collections metrics make your practice more attractive.

Reduced Financial Stress

Eliminate the anxiety of aging accounts receivable and mounting unpaid claims. Sleep better knowing experienced specialists are systematically working every dollar owed to your practice with proven results.

Competitive Advantage

Strong cash flow allows you to invest in new technology, hire top talent, and expand services while competitors struggle with collections. Your financial stability becomes a strategic advantage.

Sustainable Practice Growth

Recovered revenue becomes working capital for expansion. Open new locations, add providers, launch new service lines, or upgrade equipment knowing your financial foundation is solid and optimized.

Studies show 2-5% of all payer payments contain variances; without systematic detection, these underpayments are accepted as final and represent permanent revenue loss.

The Details of AR Management Coding

Deep expertise your billing team can act on immediately to recover outstanding revenue.

01

Aging Bucket Analysis and Strategic Prioritization for Maximum Recovery

Effective AR management begins with disciplined aging bucket analysis that prioritizes follow-up based on both dollar value and collection probability. The 0-30 day bucket requires monitoring, not active follow-up. Claims in the 31-60 day window should trigger initial payer status checks. The 61-90 day bucket is the critical inflection point where collection probability begins declining sharply and requires aggressive follow-up including phone calls and portal checks. Beyond 90 days, collection probability drops below 50%; beyond 120 days it falls below 25%. Strategic prioritization combines claim dollar value, payer payment history, denial reason recoverability, and timely filing deadlines. A weighted scoring system focusing on the 61-90 day bucket high-dollar claims maximizes recovery from limited follow-up capacity.

Key Takeaways
Claims beyond 90 days have less than 50% collection probability; beyond 120 days it drops below 25%, making early intervention in the 31-60 day window critical.
Weighted prioritization scoring combining claim age, dollar value, payer history, and denial recoverability ensures AR teams work the highest-impact claims first.
Initial payer status checks at 31 days catch processing delays, pending requests, and early denials before they age into harder-to-recover categories.
Timely filing deadline tracking by payer is essential; a single missed deadline on a high-dollar claim results in permanent, unappealable revenue loss.
02

Denial Pattern Recognition and Systematic Appeal Strategies

Denial management is the cornerstone of effective AR recovery. The most successful practices treat denials not as individual events but as data points in a pattern that reveals systemic revenue cycle weaknesses. Every denied claim should be categorized by CARC/RARC code, payer, CPT code, provider, and date range to build a comprehensive denial database. Analysis reveals actionable patterns: if a specific payer consistently denies 99214 visits for insufficient documentation, the root cause may be a documentation template issue, not a payer processing error. First-level appeals should be filed within 48 hours of denial receipt with targeted documentation. Second-level appeals should include peer-reviewed literature or specialist opinion letters. Tracking appeal outcomes by payer and denial reason reveals which denials are worth appealing and which should be corrected at the source.

Key Takeaways
Categorize every denial by CARC/RARC code, payer, CPT code, and provider to build pattern data that reveals systemic revenue cycle weaknesses.
First-level appeals filed within 48 hours of denial receipt have 40-60% higher overturn rates than appeals filed after 14 days.
Root cause analysis often reveals front-end process failures in authorization, eligibility verification, or documentation that are cheaper to fix than to appeal repeatedly.
Track appeal ROI by payer and denial reason; some denial categories have 70%+ overturn rates while others have less than 10%, enabling strategic resource allocation.
03

Payment Variance Detection and Contractual Underpayment Recovery

Payment variance analysis is one of the most overlooked yet financially impactful components of AR management. Studies consistently show 2-5% of all payments contain variances that go undetected without systematic review. These include incorrect fee schedule application, improper bundling of separately billable services, incorrect modifier processing, and arbitrary downcoding without clinical justification. Detection requires maintaining a current fee schedule database for every contracted payer and automatically comparing each payment against expected reimbursement. ERA data should be parsed to flag payments below 95% of the expected contracted rate, routing flagged claims to a variance resolution team. Practices implementing systematic payment variance detection typically recover 2-4% of net revenue that would otherwise be permanently lost as accepted underpayments.

Key Takeaways
2-5% of all payer payments contain variances; without systematic detection, these underpayments are accepted as final and represent permanent revenue loss.
Automated ERA parsing comparing every payment against contracted rates and flagging payments below 95% of expected reimbursement catches variances manual review misses.
Common variance types include incorrect fee schedule application, improper bundling of separately billable services, and arbitrary downcoding without clinical justification.
Underpayment recovery has separate contractual timelines; practices implementing systematic variance detection recover 2-4% of net revenue annually.

Understanding Payers for AR Management Billing

Effective AR management requires understanding which CPT codes drive the highest dollar volume in aging buckets, generate the most frequent denials, and carry the greatest financial impact when left unworked.

High-Volume E/M Codes

CodeDescriptionEst. RangeAR Notes
99213Office visit, established patient, low MDM - highest volume in AR aging$75-$110
Most frequently appearing code in AR aging buckets due to sheer volume. Small underpayments per claim compound into significant revenue loss. Monitor contracted rates closely.
99214Office visit, established patient, moderate MDM - frequent denial target$110-$165
Second most common code in AR. Frequently denied for insufficient documentation or downcoded to 99213. Track denial patterns by payer monthly to identify systemic issues.
99215Office visit, established patient, high MDM - highest single-claim E/M value$150-$225
High-value E/M code with elevated denial risk. Medicare and MA plans audit this code aggressively. Ensure documentation supports high-complexity MDM before pursuing appeals.

Emergency Services

CodeDescriptionEst. RangeAR Notes
99283Emergency department visit, moderate complexity$120-$200
Commonly underpaid by commercial payers. No Surprises Act protections apply for out-of-network emergency claims. Track IDR outcomes for payer-specific payment trends.

High-Dollar Procedures

CodeDescriptionEst. RangeAR Notes
92928Percutaneous coronary stent placement, single vessel$1,800-$3,500
High-dollar code frequently denied for prior authorization failures or bundling issues. A single unpaid claim at this level justifies dedicated follow-up resources.
27447Total knee arthroplasty$1,500-$3,000
Common high-dollar surgical code. Denials often relate to medical necessity documentation or prior authorization. Appeals require operative report and clinical justification.
43239Upper GI endoscopy with biopsy$250-$500
Frequently denied when billed with E/M on same day without modifier 25. Bundling edits with pathology codes are a common denial pattern requiring modifier resolution.

Diagnostic Imaging

CodeDescriptionEst. RangeAR Notes
70553MRI brain without contrast then with contrast and further sequences$350-$700
Prior authorization required by most commercial payers. Common timely filing risk when authorization delays push claim submission past payer deadlines.
73721MRI any joint of lower extremity without contrast$250-$500
High-volume imaging code frequently denied for missing prior authorization or insufficient clinical indication. Track authorization-to-claim conversion rates.

Behavioral Health, Dermatology, and Inpatient

CodeDescriptionEst. RangeAR Notes
90834Psychotherapy, 45 minutes$80-$130
Behavioral health codes have high denial rates due to session documentation requirements and authorization limits. Track remaining authorized sessions to prevent denials.
17000Destruction of premalignant lesion, first lesion$60-$120
Commonly denied when billed with E/M without modifier 25 or when documentation does not support separate lesion destruction. High volume makes AR impact significant.
99232Subsequent hospital care, moderate complexity$75-$120
High-volume inpatient code. Frequently denied for concurrent care without modifier indicating distinct service. Hospital rounding charges age quickly without systematic follow-up.

CPT codes and reimbursement ranges are for educational reference only. Actual reimbursement varies by payer, region, and contract.

AR Management Payer-Specific Billing Tips

AR management strategies must be tailored to each payer timely filing deadlines, appeal processes, payment behaviors, and denial patterns. Understanding payer nuances is the difference between systematic revenue recovery and permanent write-offs.

Medicare (Traditional Fee-for-Service)
  • Medicare timely filing is 12 months from date of service, but initial submission should occur within 30 days to allow time for denial resolution and appeals within the filing window.
  • Medicare redetermination must be filed within 120 days of initial determination. Track all denial dates and set automated alerts at 60 and 90 days to prevent missed appeal deadlines.
  • Medicare Secondary Payer (MSP) claims require the primary payer EOB before Medicare will process the claim. Delays in obtaining primary EOB are the leading cause of Medicare AR aging beyond 90 days.
  • Know your MAC and its specific processing timelines, contact methods, and escalation procedures for stuck claims. Each MAC jurisdiction has distinct policies and processing behaviors.
Medicare Advantage Plans
  • MA plans have shorter timely filing deadlines than traditional Medicare, typically 90-180 days. Verify the exact deadline for each MA plan in your payer mix to prevent write-offs.
  • MA plan denial rates are consistently 15-25% higher than traditional Medicare. Budget AR follow-up resources accordingly and implement MA-specific denial tracking to identify plan-level patterns.
  • Appeals for MA plan denials follow different timelines: 60 days for standard reconsideration and 72 hours for expedited review. Track these separately from Medicare FFS appeal timelines.
  • MA plans frequently apply clinical editing rules beyond standard NCCI edits resulting in unexpected denials. Build a payer-specific edit library for your highest-volume MA plans.
Commercial Payers (UHC, Aetna, Cigna, BCBS)
  • Commercial payer timely filing deadlines range from 90 days (some Cigna plans) to 365 days (most BCBS plans). Maintain a payer-specific deadline matrix and prioritize AR follow-up based on approaching deadlines.
  • Commercial payer underpayment disputes require formal written requests with contracted rate documentation. Verbal disputes are typically not honored. Keep copies of all executed payer contracts accessible to the AR team.
  • Commercial payers use automated adjudication systems that apply proprietary bundling edits. When claims are incorrectly bundled, submit appeals with CCI edit documentation showing codes are separately payable.
  • No Surprises Act protections for out-of-network emergency claims create a separate payment dispute pathway through IDR. File within the 30-business-day initiation window.
All Payers - General Best Practices
  • Establish a daily AR workflow assigning specific payer groups to dedicated follow-up staff. Payer specialization allows staff to develop expertise in each payer portal and appeal process for faster resolution.
  • Implement a three-touch follow-up protocol: first contact at 35 days (payer status check), second contact at 50 days (formal inquiry), and third contact at 70 days (supervisor escalation or appeal filing).
  • Track write-off rates by category (timely filing, provider adjustment, small balance) and set maximum thresholds. Write-off rates exceeding 3% of charges warrant immediate root cause investigation.
  • Monthly AR performance reporting should include days in AR, aging distribution, collection rate, denial rate, and net collection percentage. Benchmark against MGMA standards for your specialty.

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Time to Fix Your AR Management Process

Let our experts show you how we can recover outstanding balances, reduce A/R days by 40%, and transform your collections performance. Schedule a free consultation today.

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