You did the work. The claims went out. And somewhere between submission and payment, a chunk of your revenue just stopped moving. That’s the reality for most practices we audit. Aged claims sitting in payer queues. Denials nobody’s worked. Timely filing clocks running out while the AR report keeps growing.
At One O Seven RCM, we focus on one job: getting your money out of payer systems and back into your bank account. Our accounts receivable follow-up team works claims by payer rules, not generic checklists. That means knowing each payer’s filing window, appeal logic, and escalation path.
Practices that move their healthcare accounts receivable management to us usually see Days in AR drop within the first 30 to 60 days. No long contracts. No setup delays. Just claims getting worked the way payer rules require.
A claim past 30 days without follow-up loses recovery probability fast. At 60, commercial payers reclassify it. At 90, timely filing slams shut for good. This is where AR follow up in medical billing quietly fails most billing teams.
Denial codes aren’t verdicts. They’re instructions. CO-4 signals a missing modifier. CO-97 means bundled. CO-50 is medical necessity. PR-96 is patient responsibility. Misread them and healthcare accounts receivable management becomes a write-off pipeline.
When a payer goes silent past the standard window, most teams have no plan. The claim sits in pending status with the rest of the queue. Unresponsive claims need their own workflow, payer-specific outreach, and a defined escalation timeline.
Patient accounts receivable isn’t debt collection. It’s communication. Aggressive or inconsistent handling breaks trust quickly, and the balance ages into a write-off anyway. The practice loses the money, the patient, and the long-term relationship at once.
Send us your aging report. We’ll pull it apart by payer, denial code, and aging bucket and tell you exactly where the recoverable money is sitting.
This isn’t a generic checklist we pulled off a billing forum. The One O Seven AR Recovery Protocol is a six-stage, payer-driven ar follow up process we built around the realities of US healthcare RCM, where every payer has its own filing window, appeal logic, and escalation path. It’s the same protocol we run for solo practices, multi-specialty groups, and high-volume billing operations.
Here’s how each stage works and what you get from it.
Process tells you how we work. Scope tells you what we recover. This section answers the second question. Here’s exactly what our ar follow up services and medical accounts receivable services pull back into your practice’s revenue.
Every payer has its own filing window, escalation path, and approved contact channel. We work each one accordingly. That means payer portal access for daily status checks, 276/277 transaction tracking through your clearinghouse, direct follow-up calls with documented reference numbers, and supervisor escalation when a frontline rep won't move the claim. Our ar follow up services aren't generic outreach. They follow payer-specific protocols built around how Medicare, Medicaid, BCBS, UnitedHealthcare, Aetna, Cigna, and Humana actually process their queues.
Most billing teams stop working a claim once it crosses 90 days. We don't. Aged claims recovery is its own discipline because claims sitting in the 60, 90, and 120-plus day buckets need a different approach than current AR. Our outstanding ar recovery services start by sorting aged claims into recoverable and unrecoverable based on payer history, denial reason, and remaining filing window. Then we follow up unpaid medical claims through aged claims recovery workflows that are designed specifically for what payers do to old AR.
Denials get analyzed against the denial code, EOB, and original claim data before anyone touches a keyboard. Our scope here covers medical necessity denials, timely filing denials, coding errors, authorization failures, and coordination of benefits issues. Appeal letters get drafted with payer-specific language, appeal deadlines get tracked, and second-level appeals get filed where the payer allows them. This is where accounts receivable follow-up turns into actual revenue recovery instead of just status updates.
Patient AR isn't collections work. It's communication. We handle statement generation, payment plan setup, balance clarification calls, and the coordination between what the insurance paid and what the patient actually owes. The goal is the balance gets paid and the patient still trusts your practice. Aggressive collections destroy both.
Most practices don't know they're being underpaid. Payments come in, get posted, and the AR closes out. But payers regularly pay below contracted rates, and those underpayments add up to real money over a year. We compare every payment against your contracted fee schedule, flag the gaps, and file adjustment requests on the underpaid claims. This is one of the highest-ROI services in healthcare AR, and it's the one most practices overlook.
AR follow-up isn’t one workflow run five different ways. The denial patterns, payer rules, documentation standards, and filing timelines change significantly between specialties, and healthcare accounts receivable management only works when those differences get respected. We build specialty-specific follow-up workflows because the same denial code means different things in behavioral health than it does in DME.
One O Seven provides claim denial management services across all 50 states, including the six WISeR model states: New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington, where new prior authorization workflows are now required.
Every specialty has unique payer denial patterns. Our claim denial management services team maps the most common denial triggers for your specialty by payer before we start.
Most practices ask the same question before committing to medical accounts receivable outsourcing services: why pay an outside company to do something we could hire for internally? Fair question. Here are six honest answers that hold up under a CFO’s scrutiny.
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