Accounts Receivable and Denial Management Services
Accounts Receivable and Denial Management Services to recover lost revenue, fix denied claims, and streamline AR for your medical practice.
Every denied claim has a reason. Every aging balance has a deadline. And every day nothing is done about them. Your practice loses revenue it has already earned.
Most practices do not have the bandwidth to work every denial, follow up with every payer, and reconcile every underpayment. That is exactly where revenue disappears, quietly, consistently, month after month.
GenMediTech handles your entire AR and denial management process so your practice stops losing what it has already earned.
- 98% First Pass Clean Claim Rate
- 24–48 Hours Claim Turnaround
- 30% Reduction in A/R
- 100% HIPAA-Compliant
Where Your Revenue Is Getting Stuck ?
Practices do not lose revenue all at once. It disappears claim by claim across the same repeating problems.
Denials Sitting Unworked
A denied claim does not pay itself. Every day it sits unworked is a day closer to the timely filing deadline. Once that window closes the revenue is gone permanently.
AR Aging Past 90 Days
Claims beyond 90 days have a significantly lower recovery rate. The longer a balance sits the harder it becomes to collect. Payers stop responding and the window closes.
Same Denial Repeating Every Month
Resubmitting without fixing the root cause just gets the claim denied again. The same coding error, the same missing modifier, the same documentation gap, month after month, until someone actually fixes it.
Timely Filing Deadlines Missed
Every payer has a filing limit, typically 90 to 365 days from the date of service. Miss it and the claim cannot be resubmitted. That revenue is gone for good.
Our AR and Denial Management Services
Denial Management and Root Cause Analysis
Every denial gets reviewed for the exact reason it was rejected. Coding error. Missing modifier. Authorization issue. Eligibility problem. We fix the root cause before resubmission so the same denial does not come back.
Denial Appeals
We prepare formal appeals with complete supporting documentation, medical records, coding rationale, and payer-specific appeal requirements. Every appeal is built to overturn the denial.
AR Follow-Up and Recovery
Outstanding AR is worked on a structured cadence by aging bucket, payer, and claim value. High-value aging claims get priority. Nothing sits without active follow-up.
Timely Filing Management
We track filing deadlines per payer and prioritize claims approaching their limit. No claim loses its window because follow-up was delayed.
Underpayment Identification and Recovery
Every payment is reconciled against your contracted rate. Underpayments are identified, documented, and disputed — recovering revenue most practices never knew they were missing.
Payer-Specific Follow-Up
Every payer has its own follow-up process — phone queues, online portals, written correspondence. We use the right approach for each payer to get faster resolutions.
Claim Resubmission
Corrected claims go back out clean — with the right codes, modifiers, and documentation formatted to each payer’s specific requirements.
Patient Balance Collections
Co-pays, deductibles, and self-pay balances are followed up professionally — improving collections without damaging the patient relationship.
Monthly AR Reporting
Every month you receive a clear report covering denial categories, AR aging by payer and bucket, recovery rate, and outstanding balances. Full visibility. No surprises.
Common Denial Reasons We Resolve
CO-4 covers procedure code inconsistent with the modifier. CO-11 is a diagnosis inconsistent with the procedure billed. CO-16 means the claim is missing information needed for adjudication. CO-22 indicates the claim was submitted to the wrong payer. CO-29 is timely filing limit exceeded. CO-97 means the benefit is included in payment for another service already adjudicated. PR-1, PR-2, and PR-3 cover patient responsibility amounts — deductible, co-insurance, and co-payment. OA-23 is claim adjusted due to prior authorization not obtained.
How Our Process Works
AR Audit and Prioritization
We start with a full review of your current AR. Claims are categorized by age, payer, denial reason, and value. High-priority buckets get worked first.
Denial Root Cause Analysis
Every denied claim is reviewed for the specific reason it was rejected. We identify patterns across payers, codes, and documentation gaps.
Correction and Resubmission
Root causes are fixed at the source. Claims go back out with the right codes, modifiers, and supporting documentation attached.
Appeals for Complex Denials
Medical necessity denials, contract disputes, and authorization-related denials get formal appeals with complete documentation.
Active Payer Follow-Up
We follow up with every payer on every submitted and resubmitted claim until resolution is confirmed.
Underpayment Recovery
Payments are reconciled against contracted rates. Every short payment is documented and disputed through the correct payer channel.
Monthly Reporting
Clear monthly report covering denial categories, recovery rates, AR aging, and outstanding balances.
AR and Denial Problems We Fix Every Day
Same denial repeating every month?
We find the root cause, fix it at the source, and make sure it does not come back next month.
Claims aging past 90 days with no payer response?
We contact payers directly and follow up consistently until the claim is resolved.
Appeals getting rejected?
We build appeals with complete documentation — medical records, coding rationale, and payer requirements. Appeals built correctly get overturned.
Underpayments going unnoticed?
We reconcile every payment against your contracted rate and dispute every short payment with documentation.
Timely filing deadline approaching?
We track every deadline per payer and prioritize claims at risk. No claim loses its window.
Patient balances sitting uncollected?
We send clear statements and follow up consistently, improving collections without affecting patient relationships.
Frequently Asked Questions
Denial management is the process of handling claims that have been denied by insurance payers. It involves reviewing the denial reason, fixing the issue, and resubmitting the claim for payment. A strong denial management process also tracks recurring issues and resolves them at the source so they don’t happen again.
A rejected claim is stopped before it reaches the payer, usually due to missing or incorrect details at the clearinghouse stage. A denied claim, on the other hand, is processed by the payer but not approved for payment. Since both occur at different stages, each requires a different approach to fix and resubmit.
The appeal window depends on the payer and usually ranges between 30 to 180 days from the denial date. Medicare follows a multi-level appeals process with strict timelines. We keep track of all deadlines to ensure appeals are submitted on time.
Accounts Receivable (AR) follow-up is the process of tracking unpaid or partially paid claims and contacting payers to resolve them. Without regular follow-up, claims can age beyond recovery limits, leading to permanent revenue loss.
Claim denials often happen due to coding mistakes, missing or incorrect modifiers, lack of prior authorization, patient eligibility issues, or incomplete documentation. Instead of just fixing the claim, we focus on identifying and resolving the root cause to prevent repeated denials.
Yes. Every payment is reviewed against the agreed contract rates. If a payer underpays, we identify the discrepancy, document it, and follow the proper process to recover the remaining balance.
We prioritize aging bucket, payer response patterns, and claim value. High-value claims approaching timely filing deadlines get worked first. Nothing sits without a follow-up plan.
Yes. Every workflow at GenMediTech follows strict HIPAA protocols, encrypted data handling and controlled access at every step.
Every Day You Wait Is a Day Closer to a Deadline You Cannot Get Back.
Unworked denials expire. Aging AR stops recovering. Underpayments go unchallenged. Every one of these is money your practice has already earned sitting uncollected.
Our AR and denial management specialists are ready to recover it, starting now.
