Reduce Days in A/R. Recover aged balances. Resolve denials and underpayments faster, with disciplined, KPI-driven follow-up.
A/R follow-up is the process of working unpaid claims and balances until they are paid or resolved. It includes claim status checks, denial correction and appeals, timely resubmissions, underpayment identification, and documentation coordination. Done consistently, it reduces Days in A/R, lowers % A/R over 90 days, and improves net collection rate.
The 2025–2026 RCM environment is defined by labor constraints, tougher payer scrutiny, and faster eligibility shifts. When teams triage to "easy claims," older accounts age into high-risk buckets and collectability drops, especially beyond 90–120 days.
At IntegraRCM, we run A/R follow-up like an operational system: bucket segmentation, high-yield prioritization, payer-specific playbooks, timely filing discipline, and a repeatable "touch cadence" that keeps balances moving.
The objective is simple: predictable cash acceleration through a disciplined follow-up cadence, payer-specific resolution paths, and prevention feedback loops that reduce repeat denials.
Benchmarks vary by specialty, payer mix, and system configuration. We establish baselines in onboarding and lock SLAs to measurable KPIs.
Bucket Segmentation
High-Yield Prioritization
Payer Status & Escalation
Correct / Resubmit / Appeal
Underpayment Recovery
KPI Reporting & Prevention
From open balance → verified status → corrected claim → appealed denial → paid and reconciled.
| Metric | Before IntegraRCM | After IntegraRCM |
|---|---|---|
| Days in A/R | Elevated DAR due to backlog and slow follow-up | Improved DAR through touch cadence + prioritization |
| % A/R over 90 days | Aged buckets neglected; higher write-off risk | Aged A/R reduced via segmentation and escalation |
| Denial resolution cycle time | Reactive rework; inconsistent documentation mapping | Structured correction/appeal workflows and tracking |
| Underpayment visibility | Short pays discovered late (or missed) | Variance review and timely recovery routing |
| Net collections & forecasting | Limited clarity on payer delays and root causes | Dashboards + prevention loop reduce repeat issues |
Client: A multi-provider outpatient practice with a high Medicare Advantage mix and frequent documentation requests
Challenge: A/R over 90 days was rising due to denial backlogs and inconsistent follow-up. Timely filing risk increased, and underpayments were not being recovered systematically.
Results (typical outcomes after stabilization):
Note: Results vary by payer mix, specialty, and system configuration. KPIs and SLAs are defined during onboarding and reported weekly/monthly.
The 2025 "compression" period exposed a truth: manual A/R follow-up cannot keep up with higher denial volumes and more complex payer behaviors. In 2026, eligibility volatility and tighter payer controls make disciplined segmentation and proactive worklists non-negotiable.
Tip: To protect collections, keep eligibility verification and prior authorization workflows tight at the front end, A/R is fastest when errors never reach the back end.
| Model | Description | Suitable For |
|---|---|---|
| A/R Recovery (Performance-Aligned) | Targeted follow-up on aged buckets and denials, aligned to SLAs and measurable recovery goals | Practices with rising 90+ day A/R or denial backlogs |
| Dedicated Team / FTE Model | Assigned follow-up team aligned to payer mix, portals, and escalation workflows | High-volume groups and enterprises |
| Hybrid Model | Monthly retainer + variable support for peaks, special payers, or aged-bucket cleanup | Multi-specialty clinics with fluctuating volume |
Each engagement begins with onboarding: A/R aging audit, denial trend review, payer segmentation, timely filing risk scan, workflow mapping, and SLA definition.
Most organizations see early momentum in the first 30–60 days (backlog reduction and throughput), with deeper performance gains as denial clustering and prevention loops mature.
A/R follow-up is the process of working unpaid claims and balances by checking claim status, correcting errors, appealing denials, and resubmitting within filing limits until payment or final resolution is reached.
Many teams aim to touch open balances at least every 30 days. High-dollar claims and accounts near timely filing limits should be worked more frequently to protect collections.
Yes. We prioritize high-yield aged balances, track filing limits, and apply payer-specific resolution steps. We also feed root-cause findings back to prevention to reduce repeats.
Yes. We align payer rules, authorization evidence, and medical-necessity support with documented workflows and escalation paths, including structured appeal preparation and tracking.
We typically report Days in A/R, % A/R over 90 days, denial rate by payer, touch rate, appeal success rate, underpayment recovery, and net collection rate, aligned to the SLAs defined in onboarding.
Yes. We work within your PM/EHR and payer portals to submit corrections, upload documentation, monitor claim status, and maintain auditable notes for every action taken.
We'll review your aging report, denial trends, and payer delays, identify high-yield recovery opportunities, assess timely filing risk, and provide a KPI baseline with an action plan.
Audit reports are typically delivered within 10 business days.