Scope for each practice is confirmed in the engagement agreement, including systems, payers, and queues.
Old balances mix real cash with accounts that should have been closed
An aging report over ninety days often contains contractual leftovers, duplicate credits, claims that were paid and misapplied, and a smaller set of truly untouched denials. Calling all of it recovery inflates the opportunity and burns the staff. A project starts by sorting. Only the sortable remainder is worked.
What the work includes
- A coded sample or full inventory of balances over an agreed age
- Identification of unposted payments, misapplied adjustments, and credit balances
- Pursuit of items still inside filing or appeal windows
- A recommended write-off list for balances that are final
- Root-cause notes so the same inventory does not rebuild
- A close report that states what was reclassified, what was paid, and what was proposed for write-off
How the work moves
Step 1
Freeze the definition
The project names the aging cutoff, the entities, and whether patient balances are included. Moving the definition mid-project makes the result unreadable.
Step 2
Sort before outreach
Categories include paid-not-posted, rejection never worked, denial still appealable, patient responsibility, and final. Outreach starts after the sort.
Step 3
Work the open window
Items with a remaining deadline are corrected, appealed, or status-checked. Items without a deadline are not decorated with activity notes to look busy.
Step 4
Hand back a smaller, truer balance
The practice approves write-offs. The ongoing follow-up queue inherits only what is still actionable, plus the prevention notes.
Operational benefits
- A balance sheet story finance can explain
- Staff time spent on items with a remaining path
- Credits and misposts found before a recovery narrative is written
- A prevention list for the ongoing cycle
Common challenges
- Many aged items are already past filing and appeal limits
- Payer portals may no longer show the original claim
- Project fees and recovered cash are different numbers
- Cleanup without an upstream fix recreates the pile
Technology
The inventory is exported from the practice management system so it can be reconciled back to the same system. A side file that cannot be tied to encounter numbers is rejected. No consumer credit tool is implied.
Where specialty changes the work
Any specialty can accumulate aged A/R. Procedure-heavy groups accumulate dollars. Primary care accumulates counts. The sort categories are the same.
Questions
How much of our old A/R can you recover?
We will not estimate a recovery percentage from a sales call. After the inventory is sorted, the practice can see how much is still inside a deadline. That figure is an upper bound on pursuit, not a forecast of cash.
Is this the same as ongoing follow-up?
No. Ongoing follow-up keeps new claims from aging. A recovery project sorts what has already aged. Practices often need the project once and the queue afterward.
Will you write balances off for us?
We recommend. The practice approves. Write-off authority stays with the owner of the receivable.