AR and Denial
Management Services
Every denied claim has a reason. Every aging balance has a deadline. And every day nothing is done, 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 check every underpayment. That is exactly where revenue disappears, quietly, month after month.
GenMediTech handles your full AR and denial management process. So your practice stops losing what it has already earned.
Send Us a Message
Our AR & denial management specialists typically respond within 1 business day.
Claim Rate
Turnaround
in AR
Improvement
Compliant
Where Your Revenue Is Getting Stuck?
Practices do not lose revenue all at once. It leaks claim by claim, across the same repeating problems.
Denials Sitting Unworked
A denied claim does not pay itself. Every day it sits is a day closer to the filing deadline. Once that window closes, the revenue is gone for good. Around 65% of denied claims are never reworked at all (Change Healthcare/AMA), that is pure lost revenue.
AR Aging Past 90 Days
Claims past 90 days recover at a much lower rate. The longer a balance sits, the harder it is to collect. Payers stop responding and the window closes.
The Same Denial Every Month
Resubmitting without fixing the cause just gets the claim denied again. The same coding error. The same missing modifier. The same gap. Until someone fixes the root cause.
Underpayments Going Unnoticed
Payers sometimes pay less than your contracted rate. Without a reconciliation process, these short payments go unchallenged. Your practice absorbs the loss silently.
Timely Filing Deadlines Missed
Every payer has a filing limit. Miss it and the claim cannot be resubmitted. That revenue is gone.
Complete AR & Denial Management Services for Medical Practices
End-to-end AR and denial management, handled entirely by our specialists.
Denial Management & Root Cause Analysis
We review every denial 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 full documentation, medical records, coding rationale, and each payer's appeal rules. Every appeal is built to overturn the denial.
AR Follow-Up & Recovery
Outstanding AR is worked on a set schedule, 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 for each payer and prioritize claims close to their limit. No claim loses its window because follow-up was late.
Underpayment Identification & Recovery
We reconcile every payment against your contracted rate. Short payments are flagged, documented, and disputed, recovering revenue most practices never knew they were missing.
Payer-Specific Follow-Up
Every payer has its own process, phone queues, portals, and written appeals. We use the right method for each one to get faster results.
Claim Resubmission
Corrected claims go back out clean, with the right codes, modifiers, and documentation, formatted to each payer's rules.
Patient Balance Collections
Co-pays, deductibles, and self-pay balances are followed up professionally, improving collections without hurting the patient relationship.
Monthly AR Reporting
Each month you get a clear report: denial categories, AR aging by payer and bucket, recovery rate, and outstanding balances. Full visibility. No surprises.
How Our Process Works
A structured, transparent workflow — so every claim is tracked, worked, and recovered.
AR Audit and Prioritization
We review your current AR in full. Claims are sorted by age, payer, denial reason, and value. High-priority buckets get worked first.
Denial Root Cause Analysis
Every denied claim is reviewed for the exact reason it was rejected. We spot 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 documents attached.
Appeals for Complex Denials
Medical necessity denials, contract disputes, and authorization denials get formal appeals with full documentation.
Active Payer Follow-Up
We follow up with every payer on every claim until resolution is confirmed.
Underpayment Recovery
Payments are reconciled against contracted rates. Every short payment is documented and disputed through the right channel.
Monthly Reporting
A clear monthly report on denial categories, recovery rates, AR aging, and outstanding balances.
Common Medical Billing Denial Codes We Fix
We work the full range of claim adjustment reason codes (CARCs). Here are the ones we see most.
Procedure code is inconsistent with the modifier, or a required modifier is missing.
The diagnosis does not match the procedure billed.
The claim is missing information needed for adjudication.
Duplicate claim or service.
The care may be covered by another payer under coordination of benefits, so the claim needs to go to the correct primary payer first.
The timely filing limit was exceeded.
The charge exceeds the payer's fee schedule or contracted rate. Key code for catching underpayments.
The service was deemed not medically necessary by the payer.
The benefit is included in payment for another service already adjudicated (bundling).
The claim is not covered by this payer and must be sent elsewhere.
Precertification or prior authorization was not obtained before the service.
Patient responsibility: deductible, co-insurance, and co-payment.
The impact of a prior payer's adjudication on a secondary claim (a coordination-of-benefits adjustment).
Payer-Specific Rules in AR & Denial Management
Denial reasons, appeal windows, and filing limits are not the same everywhere. They change by payer. We follow the correct process for each.
Medicare
A 12-month filing limit and a five-level appeals process. We track every level and deadline.
Medicare Advantage
Most appealed denials get overturned, yet most are never appealed (KFF). We appeal the recoverable ones with full documentation.
Medicaid
Rules vary by state, and Medicaid is usually the payer of last resort. We handle coordination of benefits so secondary claims process correctly.
Commercial Payers
Blue Cross Blue Shield, UnitedHealthcare, Aetna, Cigna, Humana and others each set their own rules. We follow each payer's specific portal, form, and timeline.
Medical Billing Timely Filing & Appeal Deadlines
We track the exact deadline on every claim and prioritize the ones running out of time.
| Payer | Timely Filing Limit | First-Level Appeal Window |
|---|---|---|
| Medicare | 12 months from date of service | 120 days (redetermination) |
| Medicare Advantage | Often up to 12 months (varies by plan) | Varies by plan |
| Medicaid | Varies by state (often 90 days–12 months) | Varies by state |
| Commercial (BCBS, UHC, Aetna, Cigna, Humana) | Varies by contract (often 90–365 days) | Varies (often 30–180 days) |
Limits are set by contract and can differ from the ranges above. We track the exact deadline on every claim and prioritize the ones running out of time.
Specialty-Wise Medical Billing Denial Patterns We Handle
The codes that hit a behavioral health practice are not the ones that hit a cardiology group. We work denials with the payer rules specific to your specialty — including Psychiatry / Behavioral Health, Cardiology, OB/GYN, Orthopedics, Internal Medicine, Family Practice, Pain Management, Nephrology, Oncology, Endocrinology, and Chiropractic.
View All SpecialtiesClaims Management Across All 50 U.S. States
HIPAA-compliant remote billing workflows — including multi-state telehealth practices managing providers across multiple state licenses.
50
U.S. States
Geography is never a barrier to getting paid.
Whether you're a single-state practice or a multi-state telehealth provider, our HIPAA-compliant remote billing workflows cover every payer, in every state. No local office required — just compliant, consistent billing wherever you're licensed to practice.
Expert Billing Across All
Major EHR Platforms
Seamless integration with the most widely used practice management and billing platforms.
AR and Denial Problems We Fix Every Day
From repeating denials to unworked aging claims — we have handled it all before.
Same denial repeating every month?
We find the root cause, fix it at the source, and make sure it does not come back.
Claims aging past 90 days with no payer response?
We contact payers directly and follow up until the claim is resolved.
Appeals getting rejected?
We build appeals with full documentation — medical records, coding rationale, and payer rules. Appeals built right 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 hurting patient relationships.
Frequently Asked Questions
Everything you need to know about AR and denial management.
What is denial management in medical billing?
Denial management is the process of handling claims that an insurance payer has denied. It means reviewing the denial reason, fixing the issue, and resubmitting the claim. A strong process also tracks repeat issues and fixes them at the source, so they stop happening.
What is the difference between a denial and a rejection?
A rejected claim is stopped before it reaches the payer — usually for missing or wrong details at the clearinghouse stage. A denied claim is processed by the payer but not approved for payment. They happen at different stages, so each needs a different fix.
How long do we have to appeal a denied claim?
It depends on the payer. Commercial appeal windows often run 30 to 180 days from the denial date. Medicare follows a five-level appeals process with strict deadlines, starting with a 120-day redetermination. We track every deadline so appeals go in on time.
What is AR follow-up and why does it matter?
AR follow-up is the process of tracking unpaid or partly paid claims and contacting payers to resolve them. Without regular follow-up, claims age past recovery limits and the revenue is lost for good.
What are the most common reasons for claim denials?
The top drivers are missing or inaccurate data, missing authorizations, and incomplete patient information (Experian State of Claims 2025). Other common causes are coding errors, missing modifiers, and eligibility issues. We fix the root cause, not just the single claim.
Do you recover underpayments?
Yes. We review every payment against your contracted rate. If a payer underpays — often flagged by code CO-45 — we document the discrepancy and follow the correct process to recover the balance.
How do you prioritize AR follow-up?
We prioritize aging bucket, payer response patterns, and claim value. High-value claims near a filing deadline get worked first. Nothing sits without a follow-up plan.
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.