Aged A/R Cleanup
Old A/R is not a staffing problem. It is an order-of-operations problem.
Aged claims sit because worklists get worked newest-first and easiest-first. We take the inventory, sort it by filing deadline and recoverability, and work every account to a decision — paid, appealed, patient-billed, or written off with a reason on record.
A/R by aging bucket
Illustrative
Illustration of how a healthy aging profile is distributed. Your own split is produced in the inventory phase from your system, not from this example.
24%
Fewer days in A/R
average reduction after onboarding
94%
Appeals overturned
of denials we appeal
Deadline first
Worklists ordered by timely filing
not by balance size
Fixed scope
Cleanup can be a project, not a contract
with a defined start and end
HOW WE MEASURE IT
One A/R number hides everything that matters
A blended days-in-A/R figure can look stable while a single payer quietly ages past filing. The measurement change comes before the work.
What most practices measure
- Total A/R dollars, as one number
- Days in A/R, blended across every payer
- Collections this month versus last
- Whoever is loudest in the worklist
What we measure instead
- A/R by bucket, payer, and denial reason
- Dollars at risk inside the next filing window
- Recoverable versus uncollectible, stated separately
- Resolution rate per worklist, per week
Six tiers, and what happens in each
Every aged account lands in exactly one tier. You see the split before work starts, so the recovery estimate is based on your inventory rather than on optimism.
Tier 1 — at risk
Claims approaching a timely-filing or appeal deadline.
Worked first, regardless of balance. Filing proof assembled where a payer disputes receipt.
Tier 2 — high recoverability
Clean claims with a fixable defect: coding, COB, auth reference, or eligibility.
Corrected and resubmitted with the original claim reference carried through.
Tier 3 — appealable
Denied on medical necessity, level of care, or bundling.
Appeal packaged on the clinical record and tracked to a decision.
Tier 4 — payer stalled
Claims acknowledged but unpaid past the payer's own turnaround window.
Escalated to provider representatives with reference numbers and contact history.
Tier 5 — patient responsibility
Balances that moved to the patient after adjudication.
Statements and support handled on your rules, with a defined stop point.
Tier 6 — uncollectible
Past every deadline or correctly denied.
Presented for write-off with the reason, so the adjustment is a decision rather than a surprise.
THE PROJECT
A cleanup with a start and an end
Phase 1 — inventory
We take the full aged inventory, reconcile it against your system, and hand back a bucketed picture: what is there, how old, with which payer, and how much of it is realistically collectible.
Phase 2 — triage
Every account lands in one of six tiers. You see the split before work begins, so the scope and the expected outcome are agreed rather than assumed.
Phase 3 — work the tiers
Deadline-risk accounts first, then recoverability order. Each account is worked to a resolution — paid, appealed, patient-billed, or written off with a reason.
Phase 4 — close and hand back
A closing report: dollars recovered, dollars written off and why, and the upstream causes that created the backlog so it does not rebuild.
A/R recovery questions, answered plainly
How old is too old?
It depends on the payer's timely-filing and appeal windows, not on a single number. Some aged claims are recoverable well past a year with proof of timely filing; others are closed at 90 days. Part of the inventory phase is telling you plainly which is which.
Do we have to change billing vendors to use this?
No. A/R recovery is deliberately a standalone, fixed-scope engagement. Many practices bring us in for a backlog after a system migration, a staffing gap, or a vendor change while their current billing continues untouched.
How is it priced?
As a percentage of collections — the only model we use. On a cleanup that means a percentage of what we actually recover, so you pay on dollars that reach your account. We quote the rate after seeing the inventory, because pricing a cleanup before looking at it either overcharges you or guarantees the easy accounts get worked and the rest do not.
Will you work patient balances too?
If you want them included. Patient balances follow your rules — statement cadence, discount policy, and the point at which an account stops being pursued. We do not invent a collections policy on your behalf.
What stops the backlog from coming back?
The closing report names the causes: unowned worklists, missing eligibility checks, denials never classified, or provider enrollment gaps. Fixing those is either handled by your team or becomes a continuing scope with us.
Can you work in our system?
Yes. We work inside your existing EHR/PM and clearinghouse so notes, claim history, and adjustments stay in your record and remain auditable after the project ends.
Where A/R recovery leads
Denial Management & Appeals
The continuing workflow that keeps a cleaned-up A/R from rebuilding.
Revenue Cycle Management
When the backlog was a symptom and the whole cycle needs one owner.
A/R & Denial Benchmark Tool
Enter six numbers and see your aging and denial rate against published bands.
Send us your aging report
We will bucket it, flag what is inside a closing filing window, and come back with a fixed scope for the cleanup — including the part we think is not worth chasing.
How does your A/R and denial rate compare?
Free benchmark tool — enter six numbers, see your bands against published industry sources, and download a branded PDF.