Aging AR is a specific problem with a specific solution. The solution is not working harder in general — it’s triage, prioritization, and systematic recovery in the right order. Working claims randomly out of a large AR backlog recovers 40–60% of what’s recoverable. Working them in the right order recovers 80–90%.
The AR Recovery Triage Framework
Before working a single claim, sort your open AR into four buckets and work them in this exact order:
| Bucket | Claims | Why This Priority |
|---|---|---|
| Priority 1: Emergency | Any claim within 15 days of timely filing deadline | Once timely filing passes, recovery is permanently impossible. These are your only true deadline-driven items. |
| Priority 2: High-Value Actionable | Claims over $500, age 30–90 days, denial reason is correctable | Best return per hour of work. CO-4, CO-16, CO-22 corrections take 15–30 minutes and recover hundreds of dollars. |
| Priority 3: Standard Recovery | Claims under $500, age 30–90 days, or medical necessity appeals | Important but not urgent. Medical necessity appeals take longer to prepare and have longer payer response times. |
| Priority 4: Evaluate for Write-Off | Claims over 90 days with exhausted appeals, or claims under $50 that would cost more to collect than they’re worth | Some AR is not economically recoverable. Carrying it on the books inflates your AR metric and distracts from recoverable claims. |
What’s Recoverable vs. What Isn’t
Recoverable: Denials within the appeal window with a specific correctable error. Timely filing denials where you have proof of original timely submission. Medical necessity denials where the clinical documentation supports the service. Auth denials where retroactive authorization was obtained.
May be recoverable with effort: Coordination of benefits denials where primary/secondary order is unclear. Old claims where the patient’s coverage history needs reconstruction. Denials on terminated providers where back-dating of credentialing can be documented.
Not recoverable: Claims past timely filing with no proof of original submission. Denials on services that genuinely weren’t covered under the patient’s plan. Claims where the appeal window has also closed. Claims for services rendered to patients with no active coverage and no ability to pay.
Payer-Specific Appeal Deadlines
| Payer Type | Appeal Window (typical) | Timely Filing Limit |
|---|---|---|
| Medicare (Part B) | 120 days from initial determination | 12 months from date of service |
| Medicare Advantage | 60 days (varies by plan) | 90–365 days (varies by plan) |
| Medicaid (state-specific) | 30–90 days (varies by state) | 90–365 days (varies by state) |
| BCBS | 180 days from denial date | 180 days from date of service |
| United Healthcare | 180 days from denial date | 90–180 days from date of service |
| Aetna | 180 days from denial date | 180 days from date of service |
| Cigna | 180 days from denial date | 90–180 days |
The 30-Day AR Recovery Sprint
When a practice has a significant AR backlog — more than 20% of total AR over 90 days — a focused 30-day sprint can recover the majority of recoverable claims:
Days 1–3: Triage the full AR. Pull every open claim, sort into the four buckets above. Identify all Priority 1 emergency claims and work them immediately regardless of amount.
Days 4–15: Work Priority 2 high-value actionable claims. Corrections first (fastest recovery), then appeals. Submit corrected claims and appeals daily — don’t batch.
Days 16–25: Work Priority 3 standard recovery. Prepare medical necessity appeals for each eligible denial. Submit with full clinical documentation.
Days 26–30: Review Priority 4 evaluate-for-write-off claims. Any that gained new information during the recovery sprint (new coverage identified, retroactive auth obtained) move up. Remainder go to write-off queue with documented reason.
Ongoing from Day 30: Daily AR management to prevent a new backlog from forming. Denials worked within 5 business days of receipt. Appeals followed up at 30 days. Any claim over 25 days with no response triggers a payer follow-up call.
What a Dedicated AR Recovery Specialist Does Differently
The difference between a general biller doing AR recovery and a dedicated specialist is systematic knowledge of payer-specific appeal requirements. Medicare medical necessity appeals require specific language about the CMS LCD for the service. United Healthcare appeals go through a specific portal with a specific format requirement. BCBS in some states requires appeals in writing via a specific fax number to a specific department. A generalist learns these requirements by trial and error. A specialist already knows them.
Dr. Billerz AR recovery engagements start with the triage framework above, prioritize based on dollar value and recovery probability, and track every open appeal through to resolution. The free 4-week pilot includes the initial AR audit and recovery sprint setup at no cost.
Frequently Asked Questions
How do you recover old medical billing claims?
Triage by timely filing proximity first (emergency tier), then by dollar value and correctability. Correctable errors (wrong modifier, missing field) resolve in 24-48 hours as corrected claims. Medical necessity denials require formal appeals with clinical documentation — 2-5 days to prepare, 30-90 days for payer response. Claims past timely filing with no proof of original submission are generally unrecoverable.
What percentage of denied medical claims can be recovered?
With systematic AR recovery, 60-80% of denied claims within the appeal window are recoverable. Key factors: how quickly recovery starts after denial (earlier = higher recovery rate), whether timely filing windows are still open, and whether the denial has a specific correctable error vs. a medical necessity dispute (corrections recover faster and at higher rates than medical necessity appeals).
How long does AR recovery take?
A focused 30-day sprint addresses the immediate backlog. Correctable errors resolve in days. Medical necessity appeals resolve in 30-90 days. Full AR normalization (90+ day bucket back under 10% of total AR) typically takes 60-90 days of dedicated recovery work for a practice with a significant backlog.
AR over 90 days above 15%? Start the free pilot — the intake audit identifies your highest-priority recovery claims on day one.
Related Resources
How to reduce days in AR | What to do when a claim is denied | Systematic denial reduction guide