Revenue Cycle Management Services

Yes. We recover patient responsibility balances (copays, deductibles, and coinsurance) after insurance adjudication, and we follow up on unresolved payer claims such as denials and underpayments. They are different kinds of receivables and we run a different process for each, but most healthcare clients place both with us.

A BAA is the HIPAA-required contract between a healthcare provider (the covered entity) and a vendor that handles protected health information on its behalf. It defines how PHI may be used, disclosed, and safeguarded. We sign a BAA with every healthcare client before any account data is transferred. It is the first step in every engagement.

All of our medical recovery work is priced on contingency. You pay a percentage of what we actually collect, with no retainer, no setup fee, no per-account charge, and nothing owed on accounts we do not recover. Your rate depends on account age, account type (patient balances and insurance follow-up are priced separately), average balance size, and placement volume. You receive a written rate schedule before we touch the first account, and the rate does not change after placement.

Medical billing is the front end: translating care into CPT and ICD-10 codes, submitting claims, and posting payments. Revenue cycle management is the full financial lifecycle of a patient encounter, from scheduling and eligibility through charge capture, claim submission, denial management, and final payment. Medical AR recovery, which is what we do, starts after billing has run its course and resolves what the billing process could not, including aged patient balances and unresolved payer claims.

Yes. Beyond patient balances, we work unresolved payer receivables, including claims that were denied, underpaid, or left pending after adjudication. We review the remittance details, identify why the claim stalled, and pursue the appropriate follow-up or appeal with the payer. Many practices place both patient responsibility balances and payer claim follow-up with us, because they are different kinds of receivables that each require their own process.

Early-out outreach works patient balances in the first 30 to 90 days, before they harden into bad debt, often using statements and calls under your practice’s name. Accounts handled early generally resolve at higher rates, preserve the patient relationship, and reduce the volume that ever reaches third-party status. Third-party collections handle older balances that have already aged out of your internal process. We offer both and help you match the right program to the age and mix of your receivables.

Yes. Patient balance recovery is consumer collection work, so it is governed by the FDCPA along with the TCPA, Regulation F, and applicable state rules. Our outreach follows a documented sequence of statements, calls, and payment plan options designed to treat your patients with respect while staying within those regulations. Handling patient communications compliantly protects your practice’s reputation and the relationship you have with the people you treat.

For each account we typically need the patient or guarantor contact information, the balance owed and what it represents (patient responsibility versus a payer claim), the date of service, and the relevant billing and remittance detail. Most healthcare clients send this securely from their practice management or billing system. All account data moves through secure channels under the Business Associate Agreement we sign before any records are transferred.

It depends on your goals. For early-out work, placing balances at 30 to 90 days captures them while they are most collectible and keeps them out of bad debt. For aged accounts, the sooner you place them the better, because recovery rates generally decline as balances get older and contact information goes stale. We cannot promise a specific recovery amount, but working accounts sooner gives every program the best chance to succeed.