Denial Appeals and A/R Recovery
Written by Corey Blackburn, DPM, Founder
Prairie Specialty Billing works denied claims and aging accounts receivable for practices that already have a biller, and for practices that want full-service billing. We check claims before they go out, appeal denials, and follow balances that have not been paid.
What does Prairie take on?
We take pre-submission claim checks, denial appeals, aging accounts receivable, payment posting, and patient statements. Patients receive up to three statements. After those statements and soft collection attempts, we work with the collection agency the practice prefers. A practice can ask for this work without sending every new claim to us.
What does aging mean?
Aging is how long a balance has gone unpaid. Practices usually group balances at 30, 60, 90, and 120 days and older. Older balances are harder to collect because filing limits, payer records, and patient contact all get worse with time. Those day labels are buckets. They are not a recovery rate.
What happens to old A/R when you change billing companies?
The prior company’s open claims do not move on their own. Someone has to list what is unpaid, what was denied, what is still pending, and what was never submitted, then decide who will work each group. Prairie can work that older inventory. We do not quote a percentage recovered.
Timely filing
Medicare fee-for-service claims generally must be filed no later than one calendar year after the date of service. A claim denied because it was late is not appealed the way a medical-necessity denial is. Other payers set their own limits. We check the limit before spending time on a balance that can no longer be billed.
A recovery percentage and a turnaround time for old accounts receivable are not stated here. Most consultations are scheduled within two business days.