AR Follow-Up and Recovery Services That Turn Open Claims Into Cash
Every unpaid claim worked before it ages. Every aged claim chased before it's lost.
Your AR report is a list of money payers owe you. Our California AR specialists work it claim by claim: checking status, calling payers, correcting and resubmitting, appealing and escalating, in order of dollar value and filing deadline. For backlogs and legacy AR, we run recovery projects where you pay only on what we collect.
- Claims followed up from day 30
- Prioritized by value and deadline
- Pay-on-recovery option for aged AR
- HIPAA compliant with signed BAA
What Are Accounts Receivable Management Services?
Accounts receivable (AR) is the money payers and patients owe your practice for care already delivered. Accounts receivable management services keep that balance moving: every open claim is tracked, followed up and resolved until it is paid, corrected, appealed or properly adjusted.
The ongoing work on current claims, usually starting when a claim hits 30 days without payment.
The focused effort on aged balances, typically 90 days and older, that in-house teams have stopped working.
Both use the same skills: reading claim status, knowing each payer's rules and acting before the deadline closes.
AR Benchmarks Every Practice Should Know
| Metric | Commonly cited healthy range | What it tells you |
|---|---|---|
| Days in AR | Under 40 days | How long it takes, on average, to get paid |
| AR over 90 days | Under 15–20% of total AR | How much money is at real risk of loss |
| Net collection rate | 95% or higher | How much of what you're owed you actually collect |
| First-pass resolution rate | 90% or higher | How many claims pay without rework |
Widely used industry ranges (MGMA, HFMA).
AR Follow-Up Services That Keep Every Claim Moving
Two engagements, one team: ongoing follow-up to stop claims from aging, and recovery projects to collect the ones that already have.
Ongoing AR follow-up
Claim Status Follow-Up
Every claim with no payment at 30 days is checked through 276/277 status inquiries, payer portals and live calls, and the next action is logged.
AR Calling Services
Experienced callers reach payer representatives, get reference numbers and push stalled claims through reprocessing, so nothing sits in “pending” indefinitely.
Corrections and Resubmissions
Claims held for missing information, COB updates, invalid codes or wrong payer are fixed and resubmitted the same week.
Records and Information Requests
We answer medical records requests and additional-information letters fast, because an unanswered request quietly becomes a denial.
Underpayment Recovery
Every payment is checked against your contracted rate, and short pays are disputed with the payer or IPA.
Old AR recovery services
Aged AR and Backlog Clean-Up
Claims 90, 120, 180 and 365+ days old are triaged by collectibility, worked by dollar value and closed out: paid, appealed, rebilled to the right payer or properly adjusted.
Timely Filing Rescue
For claims past the payer's deadline, we build proof of timely filing from clearinghouse acceptance reports and 277CA acknowledgments, and appeal with it.
System Conversion and Run-Out AR
When you switch EHRs, PM systems or billing companies, we work the legacy AR so your team can focus on the new system.
Credit Balances and Overpayments
We resolve credit balances, process refunds correctly and contest improper recoupments within the allowed window.
Workers' Comp, TRICARE and Specialty Payers
Complex payers with their own rules, worked by specialists who know them.
Denials in your AR? See our Denial Management Services →
How We Work Every AR Aging Bucket
A claim at 35 days and a claim at 200 days need completely different work. We match the action to the age.
0–30 days
Claim submitted, in payer processing
Confirm acceptance (277CA), catch clearinghouse rejections the same day
31–60 days
No payment, no denial
Status check, payer call, answer any pending information request
61–90 days
Stalled, pended or partially paid
Escalate with payer, fix COB or coding holds, dispute underpayments
91–120 days
At risk; often a hidden denial or lost claim
Full claim review, corrected claim or appeal, rebill to the right payer
121–365 days
Aged AR most practices stop working
Recovery triage by collectibility and value, appeal with proof of timely filing, provider dispute
365+ days
Legacy AR, often from a system change or past vendor
Collectibility screen, targeted appeals on viable claims, clean write-off on the rest
How We Prioritize
Every open claim is scored on three factors: dollar value, days left before the payer's filing or appeal deadline, and likelihood of payment. High-value claims close to a deadline get worked first. Small balances are batched by payer so they're worth pursuing.
AR Follow-Up Services in California: The Rules That Get You Paid
California law sets minimum deadlines, payment clocks and dispute rights that protect providers. We use every one of them to collect.
Timely Filing Floors and Limits
| Payer type | Filing deadline | Source |
|---|---|---|
| DMHC-regulated plans and capitated IPAs, contracted provider | Plan cannot set less than 90 days from date of service | 28 CCR 1300.71(b)(1) |
| Same, non-contracted provider | Plan cannot set less than 180 days from date of service | 28 CCR 1300.71(b)(1) |
| Secondary claims after the primary pays or denies | At least 90 days from the primary payer's action | 28 CCR 1300.71(b)(1) |
| CDI-regulated insurers (PPO and indemnity) | Same 90 / 180-day floors | Insurance Code 10133.66 |
| Medi-Cal fee-for-service | Six months from the month of service, with limited exceptions | DHCS billing rules |
| Medicare (Noridian) | 12 months from date of service | CMS |
Your contracts may allow longer windows. We load each payer's actual deadline so no claim times out by accident.
Payment Clocks and Interest
For DMHC-regulated plans, AB 3275 requires payment of complete claims within 30 calendar days, with interest at 15% per year after that. We flag late payments and recover the interest owed.
Overpayment Demands and Recoupments
A plan must send a written notice of overpayment within 365 days of paying the claim, except in cases of fraud or misrepresentation. Providers have 30 working days to contest it, and a contested notice is handled as a provider dispute. A plan may only offset an overpayment against current claims if your contract allows it. We review every recoupment against these rules before money leaves your account.
Provider Disputes on Stalled Claims
When a plan or IPA won't pay, California providers can file a formal provider dispute within 365 days of the plan's action. The plan must acknowledge it within 2 working days (electronic) or 15 working days (paper) and decide within 45 working days. We use disputes to break claims loose that routine calls can't.
Our AR Follow-Up and Recovery Process
- 1
AR analysis
We pull your aging report and remittance history, then break AR down by payer, bucket, provider and claim status.
- 2
Collectibility triage
Every claim is scored by dollar value, deadline and likelihood of payment. You see the recoverable total before we start.
- 3
Payer-by-payer work plans
Claims are grouped by payer so each call or portal session resolves many claims at once.
- 4
Follow-up and resolution
Status checks, calls, corrections, resubmissions, appeals and provider disputes, each logged with date, reference number and outcome.
- 5
Escalation
Claims stuck past the payer's own deadlines go to provider relations, formal disputes and, where appropriate, regulator complaints.
- 6
Posting and reconciliation
Payments are matched to the claim and checked against your contracted rate.
- 7
Root-cause feedback
Patterns behind aging, such as eligibility gaps, missing authorizations or coding holds, go back to the right team so tomorrow's AR doesn't look like today's.
Turnaround commitments
Why Outsource AR Follow-Up?
AR follow-up is the work that always gets pushed to tomorrow. Front-desk and billing staff handle today's patients and today's claims first, so open balances drift past 60, 90 and 120 days. When you outsource AR follow-up, every claim has a dedicated owner and a next action date.
Faster cash
Claims are worked from day 30, not day 120, so days in AR come down.
Fewer write-offs
Deadlines are tracked by payer, so claims are appealed or rebilled before they time out.
Recovery of money you'd given up on
Aged and legacy AR gets a second, expert look, often on a pay-on-recovery basis.
Payer expertise on every call
Our callers know which California plans, IPAs and portals resolve which problems.
No new hires
Volume spikes, staff turnover and system conversions don't stall collections.
Clear reporting
You see dollars collected, claims closed and what's left, every week.
AR Recovery Services for Practices, Groups and Hospitals
Physician Practices and Groups
Ongoing follow-up and aged AR clean-up for solo practices through multi-specialty groups.
Hospitals and Health Systems
Hospital AR recovery for outpatient, emergency and professional fee claims, including underpayments and small balances.
Ambulatory Surgery Centers
High-dollar procedure claims, implant billing and multiple-procedure payment checks.
FQHCs and Community Clinics
Medi-Cal managed care follow-up and PPS reconciliation.
Practices Changing Systems or Vendors
Legacy AR worked to closure while your team learns the new platform.
Practices After Staff Turnover
Backlogs left by a departed biller, worked by deadline first.
Across California
We follow up on AR for practices in Los Angeles, Orange County, San Diego, the Inland Empire, the Bay Area, Sacramento, Fresno and the Central Coast, working the Medi-Cal plans, IPAs and commercial payers in each region.
What You Can Expect
AR Recovery and Follow-Up Pricing
| Plan | Pricing | Best for | Includes |
|---|---|---|---|
| Ongoing AR follow-up and denial management | 3.5% of monthly collections | Practices billing in-house that need back-end support | Claim status follow-up, AR calling, corrections, appeals, disputes, underpayment recovery, weekly reporting |
| Old AR recovery (contingency) | 18% of dollars recovered | Backlogs, legacy AR, AR over 90 days | Collectibility triage, recovery work, appeals and disputes; no recovery, no fee |
| System conversion run-out | 18% of dollars recovered | Practices switching EHR, PM or billing vendor | Legacy AR worked to closure in parallel with go-live |
| Bundled with medical billing | Included | Practices using our full medical billing service | AR follow-up and recovery included in your billing rate |
No setup fee, no long-term contract. The AR analysis is free and comes with no obligation.
Why Practices Trust Us
- HIPAA-compliant workflows, signed BAA and role-based system access
- Every payer contact logged with date, reference number and outcome
- California payer and IPA experience, including Knox-Keene dispute rights
- Transparent reporting on every dollar collected and every claim closed
In-House AR Follow-Up vs Outsourced AR Recovery
| In-house billing staff | California Billing Services | |
|---|---|---|
| When follow-up starts | When someone has time, often after 90 days | Day 30, every claim |
| How claims are prioritized | Oldest or easiest first | Dollar value and days left to the deadline |
| Payer calls | Squeezed between other tasks | Dedicated callers, batched by payer |
| Timely filing risk | Deadlines tracked from memory | Each payer's deadline loaded and monitored |
| California rights | Rarely used | Provider disputes, interest claims, recoupment challenges |
| Aged and legacy AR | Written off | Triaged and recovered, pay on recovery |
| Coverage | Gaps during PTO and turnover | Full team backup |
| Cost | Salary, benefits, training | 3.5% of collections or 18% on recovery only |
With contingency pricing, AR recovery costs nothing unless it puts money in your account.
AR Follow-Up and Recovery FAQs
AR follow-up is the ongoing work of tracking unpaid insurance claims and acting on them until they are paid or resolved. It includes claim status checks, payer calls, corrections, resubmissions and appeals, usually starting when a claim reaches 30 days without payment.
Can't find what you're looking for? Contact our billing specialists
Find Out How Much of Your AR Is Still Collectible
Send us your AR aging report. In five business days, a California AR specialist will show you your collectible dollars by payer and aging bucket, which claims are closest to timing out, and what it would take to bring your days in AR under 40.
HIPAA compliant · BAA provided · No long-term contract · Pay only on recovery for aged AR
Talk to an AR Specialist: (631) 652-3106What your free AR analysis shows
- Collectible dollars by payer and bucket
- Claims closest to timing out
- What it takes to get days in AR under 40
- Delivered in five business days
Keep claims clean from the start
Less aging AR starts upstream. These services stop the problems that slow payment.