Denial Management & A/R Recovery
Stop Chasing Claims. Start Collecting Them.
Most billing teams react to denials. True Care Billing predicts, prevents, and recovers revenue that was written off long ago.
The Real Cause of Revenue Loss
Practices don’t lose revenue because claims get denied. They lose revenue because:
- Denials aren’t analyzed
- A/R piles silently for months
- No one is tracking payer patterns
- Appeals are reactive instead of strategic
- Most billing firms stop after one appeal
If nobody owns denial prevention, nobody owns your cash flow.
Our A/R Recovery & Denial Intelligence System
Not just rebilling. Not resubmitting. Revenue forensic analysis + proactive escalation.
We Recover What Others Ignore:
- Aged A/R (30–120+ days)
- Underpaid claims & Silent denials
- Wrong payer-classification incidents
- Claim coding reversals
- Bundled payment errors
We Don’t “Just Resubmit”
- We investigate payer logic
- Correct root coding triggers
- Escalate with documentation
- Leverage payer clause protections
- Enforce federal reimbursement rules
Why Denials Happen (What Your Competitors Don’t Fix)
Denials aren’t random. They are predictable patterns.
Trigger
- Modifier mismatch
- Frequency limits
- Medical necessity rejection
- Bundling edits
- Credentialing lapse
- Eligibility miss
Root Cause
- Specialty coding nuance ignored
- No pre-check rules
- Missing provider narrative
- Poor CPT/ICD alignment
- Enrollment oversight
- Intake breakdown
We don’t “fix claims.” We fix the system that breaks them.
Our Outcomes
Outcome
Denial rate: up to 85%
A/R days reduced: 40–60%
Aged claims recovered: up to $500K
Appeal success rate: 92–95%
Measured Impact
Faster revenue cycles
Cash flow stability
Capital restored
Less revenue leakage
How We Recover Revenue
STEP1
A/R Triage & Categorization
- Identify aged claims (by payer, age, denial type)
- Classify salvageable lines
- Tag payer-pattern risk
STEP2
Denial Cause Mapping
We don’t just fix claim errors.
We expose denial root cause architecture.
STEP3
Corrective Submission & Escalation
- Documentation shift
- Corrective coding
- Payer escalation protocols
- Regulatory clause enforcement
STEP4
Prevention Lock
We build safeguards so the same denial never repeats.
Case Transformation Snapshot
Pain Management Group (6 Providers)
- 18% denials → 2%
- 2M aged A/R backlog
- $500K recovered within months
Primary Care Solo Practice
- 25% denials → <5%
- Collections: $20K → $38K/month
- A/R days cut in half
How We’re Different
Our Model:
- No blind resubmission
- Payer-specific correction
- Regulatory leverage
- Denial prevention metrics built-in
- Specialty-based A/R excavation
We treat denials as diagnostic data — not clerical inconvenience.
Who This Service Is For
Practices with historic backlog
Providers expanding or multi-location
Clinics with chronic 30–120 day A/R cycles
Specialty environments with complex coding rules
What You Avoid Forever
- Endless appeals loop
- Payer blackout periods
- “still pending” purgatory
- Partial reimbursements quietly accepted
- Reimbursement clawbacks
- Documentation repeats
Recover Revenue You Already Earned.
Denials aren’t lost dollars — just unclaimed ones.