Rising operating costs and delayed reimbursements can strain a practice’s cash flow. Without disciplined, ongoing follow‑up on open accounts, balances routinely age past 90–180 days. Researching, correcting, appealing, and resubmitting claims takes focused time that most in‑house teams simply don’t have. Our approach restores momentum by prioritizing the right claims, fixing issues quickly, and moving every account toward resolution.
We track every pending claim, investigate denials, correct data or coding issues, and pursue payers until payment posts. You’ll see fewer touches per claim, fewer write‑offs, and a measurable drop in A/R days. When needed, we prepare and submit timely, well‑supported appeals to overturn adverse decisions.
1.) Verify documentation & benefits
2.) Validate CPT/ICD coding and modifiers
3.) Resolve clearinghouse or payer edits
4.) Identify true denial reason/root cause
5.) Take corrective action and update claim
6.) Contact payer for status and escalation
7.) Submit appeal or reconsideration when appropriate
1.) Cost‑effective A/R follow‑up
3.) Higher throughput and productivity
4.) Experienced, accountable specialists
5.) Faster payments within target turnaround
6.) Increased A/R recovery
7.) Reduced denials and rejections
8.) Streamlined denial management workflows