A/R recovery services
We work your aging insurance balances claim by claim, starting with the dollars closest to a filing or appeal deadline.
Unpaid claims lose value every week. Once a claim passes 90 days, the chance of collecting it drops, and once it passes the payer's timely filing or appeal window it is usually gone for good. Many practices carry a large 90+ day bucket simply because nobody had time to call payers, check claim status, and resubmit what was missing.
SFA Solutions starts with an aging report sorted by payer, dollar amount and deadline. We check status through payer portals and 276/277 inquiries, call when a portal cannot answer, and take the action each claim needs: corrected claim, appeal with records, coordination of benefits update, or a reprocessing request. Claims that cannot be collected are documented with the reason so your write-offs are clean. Clients have seen up to 40% A/R reduction in selected client results, and the root causes we find feed back into your front desk and billing workflow to help keep the backlog from rebuilding.
Who this is for
A/R recovery fits practices switching billing companies, practices where a biller left and claims piled up, groups with a large 90+ day bucket, and practices that changed EHR or PM systems and lost track of claims in the transition. It also works as a one-time cleanup before you hand day-to-day billing to SFA.
Related services
What our A/R recovery service covers
Aging analysis
A/R sorted by bucket, payer, provider and dollar value, with each claim tagged by its timely filing and appeal deadlines.
Claim status checks
Portal lookups, 276/277 electronic status inquiries and payer calls, with reference numbers logged on each account.
Corrections and resubmissions
Corrected claims for coding, demographic or modifier errors, sent with the right frequency code to help avoid duplicate claim denials.
Appeals
Written appeals with records and policy citations for medical necessity, bundling, authorization and underpayment disputes.
Credit balance cleanup
Patient and payer credit balances reviewed and resolved, including overpayment refunds handled within required timeframes.
Clean write-off reporting
Uncollectible balances documented by reason, so you can see what was lost and why.
How we deliver it
Week 1
We pull your aging report, rank claims by value and deadline, and start on the claims closest to timely filing limits.
Weeks 2 to 4
We work the 31 to 120 day buckets payer by payer, batching calls so each payer conversation resolves several claims.
Weeks 4 to 12
Appeals and older claims are worked through each payer's process, with status updates on open accounts.
Ongoing
Weekly follow-up helps keep new claims from aging, and a monthly report shows the A/R trend by bucket and payer.
What happens in each A/R aging bucket
| Aging bucket | Typical action | Watch for |
|---|---|---|
| 0 to 30 days | Confirm acceptance and watch for rejections | Clearinghouse rejections that never reached the payer |
| 31 to 60 days | Status check on any claim not paid in the payer's normal cycle | Requests for records or COB information sitting unanswered |
| 61 to 90 days | Call payer, correct and resubmit or appeal | Commercial filing limits of 90 days on the original or corrected claim |
| 91 to 120 days | Escalate appeals, request reprocessing, involve provider reps | Appeal windows closing, often 60 to 180 days from the denial |
| 120+ days | Final appeals, documentation of uncollectible balances | Medicare's 12-month filing limit and state Medicaid limits |
A/R Recovery for your specialty
We bill for 28+ specialties. These are the ones we work with most.
Nurse Practitioner billing
Billing for NP-led and physician-NP practices, from the 85% Medicare rate and incident-to rules to split/shared visits and getting each NP credentialed under the right NPI.
Learn moreInternal Medicine billing
Billing for internists who manage complex, chronic patients, with E/M levels, wellness visits and care management codes captured when the documentation supports them.
Learn moreOphthalmology billing
Eye exam codes, refraction, diagnostic testing, cataract globals and high-cost injectable drugs all follow their own rules. Ophthalmology is one of the specialties we bill most often.
Learn moreQuestions about A/R recovery
How old a claim can you still collect?
It depends on the payer and whether the claim was filed on time. If the original claim was filed within the timely filing limit and you have proof, many older claims can still be appealed or reprocessed. Claims never filed within the limit are usually not collectible, although Medicare and some payers allow narrow exceptions.
Do you work patient balances too?
Our A/R recovery focuses on insurance balances. We also review patient balances that are wrong because of posting or insurance errors, and we can send patient statements as part of our billing service.
Can you take only our old A/R and leave current billing in-house?
Yes. Many practices start with a cleanup project, and we report the root causes we find so your in-house team can fix them going forward.
How do you decide which claims to work first?
We rank by deadline first and dollar value second. A $150 claim that closes in ten days comes before a $900 claim with five months of appeal time left.
What counts as proof of timely filing?
Clearinghouse acceptance reports, payer acknowledgment reports, and prior EOBs or rejection letters showing the original submission date. We collect those before appealing a timely filing denial.
Start with a free review
Tell us a little about your practice. We will look at where A/R recovery is costing you money today and walk you through what we find.
- No commitment
- Reply from an RCM specialist, typically within one business day
- No patient records needed to start
Get a free review
An RCM specialist typically replies within one business day.