Practical advice for practices, hospitals and labs that want to get paid faster.
Most denials are preventable. Verify eligibility and benefits before every visit, confirm prior authorization where required, and check patient demographics and insurance IDs at check-in. Code to the highest specificity the documentation supports, and scrub claims for errors before submission. Track denial reasons by payer and fix the root cause instead of reworking the same claim again and again. Finally, appeal every denial that is worth appealing within the payer deadline.
Old A/R is unpaid claims that have sat for 90 days or more. Many of these accounts are recoverable, as long as the payer timely-filing and appeal windows have not closed. A review sorts accounts into those that can be rebilled, appealed, corrected, or written off. The earlier old A/R is worked, the better the chance of payment, so do not let it age further.
Gather the provider license, DEA and board certificates, malpractice insurance, work history and NPI. Keep the CAQH profile complete and re-attest on time. Submit applications to each payer and follow up regularly, since enrollment can take weeks to months. Track expiry dates so re-credentialing is never missed, because lapses can stop payments.
The first-pass clean claim rate is the share of claims accepted by payers on the first submission. A high rate means fewer rejections, less rework and faster payment. It is driven by accurate registration, correct coding and thorough claim scrubbing before submission.
Ask who will be working your account and how often you will get reports. Ask how denials and old A/R are handled, how patient data is protected under HIPAA, and how credentialing is supported. A good billing partner answers clearly and is transparent about fees and results.
Lab claims depend on medical-necessity checks, correct test coding and payer-specific rules, and mistakes lead to denials and underpayments. Billing teams familiar with these rules protect lab revenue and reduce rework.
We support physicians and group practices, hospitals and laboratories across the USA.
Yes. Old and aging A/R recovery is one of our core services. We review unpaid and denied claims and work them with payers.
Yes. We manage provider enrollment and credentialing with insurance payers so providers can start billing sooner.
Call us or send a message through the contact page. We will review your billing and recommend a plan.
Talk to our team about your practice, hospital or lab. We will review your current billing and show you where revenue is slipping away.