AR Recovery Services & Old-AR Cleanup
Ongoing follow-up keeps this month's claims moving; this is the one-time project that goes back into the aged and legacy backlog you have effectively given up on. MedPrecision recovers old A/R, contractual underpayments, and abandoned denials -- and defends the Medicare take-backs that surface when old claims get re-examined -- before the timely-filing clock closes them for good.
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What Are AR Recovery Services?
AR recovery services are a bounded project that recovers cash from a practice's oldest and most neglected receivables rather than managing current claims. The scope is legacy and backlog A/R: claims left behind in a prior billing system after a conversion, aged denials that were never appealed, contractual underpayments where the payer paid below the contracted rate, and defense against Medicare recoupments and take-backs. It differs from ongoing A/R follow-up in three ways -- it is time-boxed, it targets balances already treated as uncollectible, and it works the older aging buckets (91-120 and 121+ days) that routine follow-up has passed by. HFMA benchmarks the target state: days in A/R of 30-40, and A/R over 90 days held under 10% of total.
- One-time project scope: legacy, backlog, and post-conversion A/R -- not day-to-day follow-up
- Timely-filing triage against the 42 CFR 424.44 one-year Medicare limit before balances expire
- Underpayment and contract-variance recovery where payers paid below the contracted rate (HFMA)
- Medicare recoupment and take-back defense through the five-level appeal process
AR recovery services are a one-time, project-based cleanup of the aged and legacy receivables a billing operation has stopped working -- not the day-to-day follow-up on current claims. Where our accounts receivable follow-up services keep this month's claims moving through the 30/60/90-day buckets, MedPrecision's AR recovery services go backward into the balances a practice has effectively written off in its head: claims stranded in an old practice-management system after a billing transition, denials that were never appealed, and contractual underpayments no one ever calculated. The window is narrow. Under 42 CFR 424.44, Medicare fee-for-service claims for services on or after January 1, 2010 must be filed within one calendar year of the date of service, and claims filed after that are denied outright -- so every month an old-AR backlog sits untouched, a slice of it becomes permanently non-recoverable. Our AR recovery services triage that backlog by what is still inside its filing window, quantify what is realistically collectible, and work the recoverable balances -- legacy claims, aged denials, underpayments, and take-back defense -- as a defined project with a start and an end, then hand a clean aging report back to your ongoing billing team.
Who This Service Is For
The State of AR Recovery Services & Old-AR Cleanup in 2026
Backlogs are the norm, not the exception. In an MGMA Stat poll conducted November 9, 2021, 49% of practice leaders said their days in A/R had increased that year, versus 15% who saw a decrease -- and the 2021 MGMA DataDive Cost and Revenue report put the median share of total A/R past 120 days at 13.54% in multispecialty practices. That aged tail is where recovery projects live. HFMA sets the target a cleanup restores: days in A/R of 30-40, A/R over 90 days under 10% of total, a net collection rate of at least 95%, and unnecessary write-offs under 3% of expected collections. The recoverable pool is large precisely because so little of it is worked -- KFF found HealthCare.gov insurers denied 19% of in-network claims in 2024 while consumers appealed fewer than 1% of them. And the Medicare timely-filing limit under 42 CFR 424.44 means every month of delay converts more of that pool into permanent write-off, which is why recovery is a project you run on a deadline, not a task you get to eventually.
What Is Breaking Right Now
A/R over 120 days that ongoing follow-up has passed by and staff have mentally written off
Legacy claims stranded in a prior practice-management or EHR system after a billing transition
Contractual underpayments where the payer paid below the contracted rate with no denial to flag it
Aged denials that were never appealed and are approaching their appeal or timely-filing deadline
Medicare recoupment demand letters that need a redetermination filed before Day 41 to stop the take-back
Common AR Recovery Services & Old-AR Cleanup Mistakes to Avoid
Treating old A/R as a slow-motion write-off instead of a project
Left inside routine follow-up, 121+ day balances get a token call and then age out. MGMA's data shows the longer a bill goes unpaid the harder it is to collect, so a backlog worked at normal cadence mostly expires unrecovered.
Pull the aged tail out of the daily queue and work it as a time-boxed recovery project with its own triage, targets, and end date, separate from ongoing follow-up.
Working the backlog oldest-first instead of by filing deadline
Staff burn the first weeks on the oldest or largest balances while claims two weeks from their filing limit expire silently -- under 42 CFR 424.44 a Medicare claim past one year is denied with no appeal rights.
Screen the entire backlog against payer filing deadlines first and work what is closest to expiring, regardless of a balance's age or dollar value.
Chasing denials while ignoring underpayments
Underpayments carry no denial to flag them -- the payer simply paid below the contracted rate -- so they hide in the paid column. HFMA notes these contractual variances often sit in accounts that looked resolved, quietly draining margin.
Calculate expected payment at the account level from the payer contract and reconcile it against what was actually paid, so variances surface as recoverable balances.
Rebutting a Medicare recoupment instead of appealing it
A rebuttal does not stop recoupment -- under CMS's timeline, take-backs begin by Day 41 regardless. Providers who only rebut watch the money get pulled from current payments while they wait.
File a redetermination by Day 30 of the demand letter; under Section 1893(f)(2)(A) a valid first- or second-level appeal generally halts recoupment until a decision issues.
What We Handle
Legacy A/R Inventory & Triage
We import your full aging report -- including balances stranded in a prior practice-management or EHR system after a billing transition -- and triage every open balance by age, payer, dollar value, and days remaining before its filing deadline. MGMA classifies receivables into 0-30, 31-60, 61-90, 91-120, and 121+ day buckets; recovery concentrates on the 91-120 and 121+ tiers that ongoing follow-up has already passed by.
Timely-Filing Risk Screen
Every legacy claim is screened against its payer's filing limit first. Under 42 CFR 424.44, Medicare fee-for-service claims must be filed within one calendar year of the date of service or they are denied, so we rank the backlog by which balances are about to expire and work those before anything else -- because a claim past its filing window is not a recovery target, it is a write-off.
Underpayment & Contract-Variance Recovery
HFMA notes that payers are contractually bound to pay accurately, yet underpayments -- a payment short of the contracted amount with no denial, or a partial denial -- routinely go uncaught. We calculate the expected payment at the account level, compare it to what the payer actually paid, and pursue the variance. HFMA recommends a dedicated contract-compliance function with training in contract interpretation and a defined escalation path; that is the discipline we apply to variance recovery.
Aged Denial Backlog Recovery
Un-worked denials are the largest untapped pool in most old A/R. KFF found that HealthCare.gov Marketplace insurers denied 19% of in-network claims in 2024, yet consumers appealed fewer than 1% of denied claims -- an un-worked denial backlog at industry scale. We re-open aged denials still inside their appeal and filing windows, rebuild the documentation, and appeal by root cause rather than blanket-refiling.
Recoupment & Take-Back Defense
When old claims are re-examined, Medicare overpayments surface -- CMS attributes them to incorrect coding, insufficient documentation, medical-necessity errors, and processing errors. Once a MAC issues a demand letter the clock starts: interest accrues if the debt is not repaid within 30 days, standard recoupment begins by Day 41, and delinquent debt is referred to the U.S. Treasury by days 126-150. We defend take-backs by filing a redetermination by Day 30 -- which, under Section 1893(f)(2)(A), generally stops recoupment until an appeal decision issues.
Billing-Transition & System-Conversion Cleanup
A system conversion is where A/R goes to die: balances that never migrate from the old platform keep aging while staff learn the new one. We extract open A/R from the legacy practice-management or EHR system, reconcile it against the new system, and work the orphaned balances as a standalone project so a go-live does not quietly cost you a quarter of receivables. Which source systems we can extract from is confirmed during scoping.
Overpayment Handling & 60-Day Compliance
Recovery cuts both ways: an old-AR audit can surface money the practice was overpaid. Under Section 1128J(d), a self-identified Medicare overpayment must be reported and returned to the MAC within 60 days of identification, subject to a six-year lookback. We document what is genuinely owed back versus what is a defensible payment, so a cleanup improves your compliance posture instead of creating new exposure.
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Find the Cash in Your Old A/R
Send us your aging report. We will triage it against timely-filing deadlines, show you which aged balances, underpayments, and denials are still recoverable, and scope a one-time recovery project -- separate from your ongoing follow-up -- to go get them.
Our AR Recovery Services & Old-AR Cleanup Methodology
Recoverability Triage, Not Bucket Order
We do not work an aging report from the top. Every legacy balance is scored on days remaining to its filing deadline, dollar value, denial reason, and payer behavior, and the queue is ordered by what is both collectible and closest to expiring. MGMA's aging buckets (0-30 through 121+) frame the inventory; the 91-120 and 121+ tiers are where the project concentrates.
Timely-Filing Window as the First Gate
Before a claim enters the work queue it passes a filing-limit check. Under 42 CFR 424.44 a Medicare claim more than one year past the date of service is denied -- with only narrow exceptions for administrative error, retroactive entitlement, or a Medicaid/Medicare Advantage recovery, each extending filing only through the sixth month after notification. A balance outside its window is routed to documented write-off, not wasted effort.
Account-Level Underpayment Reconciliation
For variance recovery we calculate the expected payment per account from the payer contract and fee schedule and compare it to what was actually paid -- the method HFMA prescribes for contractual underpayment recovery. Variances are pursued with the payer through a defined escalation path, the contract-compliance discipline HFMA recommends rather than one-off phone calls.
Appeal-First Recoupment Defense
Recoupments are defended on CMS's own clock. We file a redetermination by Day 30 of the demand letter because, under Section 1893(f)(2)(A), a valid first- or second-level appeal generally stops recoupment until a decision issues, while a rebuttal does not. Where warranted and in scope, appeals continue through reconsideration by a QIC, the Office of Medicare Hearings and Appeals, and the Medicare Appeals Council.
Clean Handoff to Ongoing Follow-Up
A recovery project is finished when the backlog is resolved, not left half-worked. We post recoveries, document genuinely uncollectible balances for clean write-off, handle any self-identified overpayment under the Section 1128J(d) 60-day rule, and hand a cleaned aging report to your ongoing A/R follow-up team so the aged tail does not rebuild.
AR Recovery Services & Old-AR Cleanup: MedPrecision vs Alternatives
| Feature | verified MedPrecision | In-House | Other Providers |
|---|---|---|---|
| Scope | check_circle One-time, time-boxed project targeting legacy, backlog, and post-conversion A/R with a defined end and handoff | Aged balances left in the daily queue, worked only when staff have spare time | Ongoing follow-up contract with no dedicated legacy-backlog workstream |
| Timely-Filing Triage | check_circle Entire backlog screened against payer filing deadlines first (42 CFR 424.44 for Medicare); near-deadline balances worked before all else | Deadlines tracked manually if at all; balances lost to filing limits | Aging worked oldest-first, letting near-deadline claims expire |
| Underpayment Recovery | check_circle Expected payment calculated at the account level and reconciled against contracted rates to surface variances (HFMA method) | Underpayments invisible because nothing denied to flag them | Denials worked; contractual variances not calculated |
| Recoupment / Take-Back Defense | check_circle Redetermination filed by Day 30 to stop recoupment under Section 1893(f)(2)(A); appeals carried up the five Medicare levels as scoped | Rebuttal filed (which does not stop recoupment) or demand paid without appeal | Take-backs treated as write-offs rather than appealed |
| Close-Out | check_circle Cleaned aging report, documented uncollectible list, and 60-day overpayment handling handed to your ongoing follow-up team | No defined end state; backlog rebuilds | Recovered dollars reported without a clean handoff or compliance close-out |
How the Transition Works
How we deliver ar recovery services & old-ar cleanup for your practice.
Backlog Import & Scoping
We take a read-only export of your full aging report -- and, for a post-conversion project, the open A/R from the prior system -- and agree the project scope: minimum claim age, minimum balance, payers in and out, and the engagement model. Pricing and any minimum-volume threshold are confirmed here before work begins.
Triage & Timely-Filing Risk List
The backlog is stratified by recoverability and by days remaining to each payer's filing deadline. We deliver a triaged inventory and a timely-filing risk list so the balances closest to expiring are visible and worked first, rather than working the aging report top to bottom.
Recovery Execution
We work the recoverable queue by category: re-file legacy claims still inside their window, calculate and pursue underpayments, appeal aged denials by root cause, and file rebuttals or redeterminations to defend recoupments -- documenting a specific next action on every account so nothing stalls.
Reconciliation & Handoff
Recovered balances are posted, genuinely uncollectible balances are documented for clean write-off, and any self-identified overpayments are handled under the 60-day rule. We hand a cleaned aging report back to your ongoing A/R follow-up team so the backlog does not rebuild.
What Reporting and Visibility Looks Like
Transparency is built into every engagement. You will always know where your revenue stands and what actions are being taken on your behalf.
Monthly KPI Dashboards
Track collection rates, denial trends, days in A/R, and payer-level performance with dashboards delivered on a fixed schedule.
Real-Time Claim Tracking
See claim status updates in real time so you never have to wonder where a payment stands or when follow-up is happening.
Quarterly Business Reviews
Detailed reviews with actionable recommendations covering denial root causes, payer trends, and revenue recovery opportunities.
Proactive Alerts
Automated alerts when key metrics shift, so issues are caught and addressed before they affect your bottom line.
AR Recovery Services & Old-AR Cleanup Key Terms
- Old / Legacy A/R
- Receivables aged well beyond routine follow-up -- typically the 91-120 and 121+ day buckets, or balances stranded in a prior billing system after a conversion -- that a practice has effectively stopped working. The target of a one-time recovery project rather than of ongoing follow-up.
- Timely-Filing Limit
- The deadline by which a claim must reach the payer or be denied without appeal rights. For Medicare fee-for-service it is one calendar year from the date of service under 42 CFR 424.44; commercial payers set their own, typically shorter than Medicare's. The first gate in any recovery triage.
- Contractual Underpayment
- A payment that falls short of the contracted or expected amount with no denial attached, or the result of a partial denial. Because nothing bounces, underpayments hide in the paid column; recovering them requires an account-level expected-payment calculation (HFMA).
- Recoupment (Take-Back)
- When a payer recovers a prior overpayment, typically by offsetting it against future payments. For Medicare, a MAC begins standard recoupment by Day 41 of the demand letter unless a valid redetermination is filed by Day 30 (Section 1893(f)(2)(A)).
- 60-Day Overpayment Rule
- Under Section 1128J(d) of the Social Security Act, a self-identified Medicare overpayment must be reported and returned to the MAC within 60 days of identification, subject to a six-year lookback. It governs how overpayments surfaced during an old-A/R audit must be handled.
Common Questions
Common questions about ar recovery services & old-ar cleanup.
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Get a Free Billing Audit arrow_forwardHow is A/R recovery different from ongoing A/R follow-up?
They are two different jobs. Ongoing accounts receivable follow-up is a continuous operation that works this month's claims through the 30/60/90-day aging buckets before they age out -- it is what our accounts receivable follow-up services provide. A/R recovery is a one-time, time-boxed project aimed backward at the balances that operation has already passed by: the 91-120 and 121+ day buckets, legacy claims from a prior system, un-appealed denials, and underpayments. Recovery targets money a practice has effectively given up on; follow-up prevents money from getting there in the first place. Most practices need both, but sequenced -- a recovery project cleans the backlog, and ongoing follow-up keeps it clean.
How do you decide which old claims are still worth pursuing?
The first filter is the timely-filing limit. A balance past its payer's filing window is not recoverable -- under 42 CFR 424.44, Medicare fee-for-service claims filed more than one calendar year after the date of service are denied, and commercial payers set their own limits. So we screen the entire backlog against filing deadlines before anything else and rank by what is closest to expiring. Within the still-fileable set, we weigh dollar value, denial reason, and payer behavior. MGMA's point that the longer a bill goes unpaid the harder it is to collect is the reality we work against, which is why triage -- not working the list top to bottom -- is what makes a recovery project pay for itself.
Can you recover underpayments, not just denials?
Yes, and it is often the most overlooked money in old A/R. An underpayment is a payment that falls short of the contracted amount with no denial attached -- nothing bounces, so nothing flags it, and the variance sits in the paid column looking resolved. HFMA states that payers are contractually bound to pay accurately and that contractual variances often appear in accounts not resolved through normal collection. Recovering them requires calculating the expected payment at the account level from your payer contracts and fee schedules and comparing it to what was actually paid. Whether we load your specific payer contracts, and whether variance recovery runs as a standalone project or inside a broader cleanup, is confirmed during scoping.
What happens if a recoupment or take-back comes up during the cleanup?
Re-examining old claims can surface Medicare overpayments, and CMS ties those to incorrect coding, insufficient documentation, medical-necessity errors, and processing errors. When a MAC identifies one of $25 or more it issues a demand letter, and the timeline is fixed: rebuttals are due by Day 15, standard recoupment begins by Day 41, an intent-to-refer letter goes out on days 61-90, and delinquent debt is referred to the U.S. Treasury on days 126-150. The defense is to appeal, not just rebut -- under Section 1893(f)(2)(A), a valid redetermination filed by Day 30 generally stops recoupment until an appeal decision issues, whereas a rebuttal does not. Medicare provides five appeal levels: redetermination by the MAC, reconsideration by a Qualified Independent Contractor, a hearing at the Office of Medicare Hearings and Appeals, review by the Medicare Appeals Council, and judicial review in U.S. District Court. How far up that ladder we carry an appeal is agreed at scoping.
We're switching billing systems -- will our old A/R just disappear?
That is exactly where legacy A/R is lost. In a conversion, current claims move to the new platform and the open balances on the old one keep aging while everyone learns the new system -- and by the time anyone looks back, months of filing windows have closed. A recovery project treats the old system's A/R as its own workstream: we extract the open balances, reconcile them against what migrated, and work the orphaned claims before their deadlines pass. Which prior PM or EHR systems we can extract from, and how that data is imported, is confirmed during scoping. This is also why practices clean up A/R before a sale, merger, or system go-live rather than after.
What do we get at the end of the project, and how is it scoped?
A recovery engagement is bounded, so it ends with a defined handoff: recovered dollars posted, a cleaned aging report that reflects only genuinely collectible balances, a documented list of what is uncollectible (and why) for clean write-off, and any self-identified overpayments handled under the Section 1128J(d) 60-day return rule. Scope, pricing model, minimum claim age, and minimum A/R volume are set at the start rather than left open-ended. The target we work toward is the HFMA benchmark set -- days in A/R of 30-40, A/R over 90 days under 10% of total, and unnecessary write-offs under 3% of expected collections -- and once the backlog is cleared, ongoing A/R follow-up keeps it there. We publish recovery results only from verified project data, so we will not quote you a recovery percentage until we have measured yours.
What share of aged accounts receivable is realistically recoverable by aging bucket?
There is no single fixed recovery rate per aging bucket, and for medical claims the real gate is the timely-filing window: a clean claim still inside it can recover in full, while a balance past its filing deadline recovers nothing. As a general benchmark for how recoverability decays with age, a Commercial Collection Agencies of America survey found the probability of collecting a delinquent account drops to 68.9% at three months, 51.3% at six months, 21.4% after one year, and 8.9% after two years. That steep decline is why a recovery project triages by filing deadline rather than working oldest-first. HFMA's benchmark of A/R over 90 days held under 10% of total sets the healthy state a cleanup restores.
Is accounts-receivable recovery a legitimate service, and how does it differ from a collection agency?
Yes -- accounts-receivable recovery is a legitimate revenue-cycle service, and it is not debt collection. It works balances a practice is owed by insurance payers: following up on unpaid claims, appealing denials, and recovering contractual underpayments -- the provider pursuing its own reimbursement as the original creditor. A collection agency is different: a third party pursuing a consumer's delinquent balance, usually the patient portion left after insurance, and is regulated by the Fair Debt Collection Practices Act. The CFPB notes the FDCPA covers debts primarily for personal, family, or household purposes and generally does not cover the original creditor, only third-party collectors. A/R recovery works payer claims, not patient debt, and does not report anyone to a credit bureau.
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Find the Cash in Your Old A/R
Send us your aging report. We will triage it against timely-filing deadlines, show you which aged balances, underpayments, and denials are still recoverable, and scope a one-time recovery project -- separate from your ongoing follow-up -- to go get them.
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