AR & Denial Management
A denial isn't the end of a claim — it's the start of a decision: appeal it, correct and resubmit it, or write it off. Left unworked, denials and aging receivables quietly become the largest source of lost revenue in most practices, not because the money isn't collectible, but because no one has the time or system to work them consistently. Flint RCM categorizes every denial by root cause and runs a structured follow-up cadence until aging balances are actually resolved.
Built for practices like yours.
- Practices with AR balances aging past 90 days without active follow-up
- Groups with a high denial rate and no clear pattern tracking behind it
- Practices recovering from an EHR migration, staff turnover, or a backlog that built up over months
- Any practice writing off more revenue than it should because appeals aren't getting worked
What this fixes.
- Denials that sit in a queue without ever being categorized or worked
- The same denial pattern recurring because the root cause was never identified
- Underpayments against contracted rates that go undetected
- Staff without the bandwidth to draft and track appeals consistently
The work, in practice.
Denials are rarely random — they follow patterns tied to specific CPTs, documentation gaps, or payer behavior. We sort every denial by root cause first, then work it on a defined follow-up schedule instead of treating AR as a queue to clear reactively.
- Root-cause denial categorization at the CPT and payer level
- Structured appeal drafting and corrected-claim resubmission
- Active AR follow-up on a defined 30/60/90-day cadence
- Underpayment detection against contracted fee schedules
- Aged-balance escalation for accounts that need direct payer contact
- Denial categorization by root cause
- Appeal drafting & resubmission
- AR worklists on a 30/60/90-day cadence
- Underpayment audits against fee schedules
- Aged-balance payer escalation
- Denial trend reporting back to your practice
Our process, start to finish.
Denial Received & Categorized
Every denial is logged and sorted by root cause — coding, eligibility, authorization, documentation, or payer error — not just by dollar amount.
Appeal or Correction Drafted
Depending on the cause, we draft a formal appeal with supporting documentation or correct and resubmit the claim.
Resubmission or Appeal Filed
The claim or appeal is filed within the payer's required window, tracked against the specific deadline.
Follow-Up Cadence
Balances are checked at 30, 60, and 90 days rather than left to surface only when someone happens to look.
Escalation
Accounts aging past the standard cadence without resolution are escalated for direct payer follow-up.
- AR aging by bucket (0–30, 31–60, 61–90, 90+ days)
- Denial rate broken down by root cause
- Appeal outcomes and recovery rate
- Underpayment findings against contracted rates
Common denials we watch for.
The denials worth tracking closely are the ones that repeat. A handful of causes tend to account for most of a practice's aging AR.
- CO-16 — missing or invalid information required for adjudication
- CO-29 — timely filing limit exceeded
- CO-50 — service deemed not medically necessary by the payer
- CO-197 — precertification or authorization absent
- PR-1 / PR-2 — patient responsibility (deductible/coinsurance), which needs accurate tracking even though it isn't a true denial
- Denials tagged by root cause the day they're received, not batched for later review
- Appeals drafted with the specific documentation each payer requires, not a generic template
- AR aging reviewed on a fixed 30/60/90-day schedule, so nothing ages past the point of easy recovery
- Underpayments checked against your actual contracted rates, not just flagged as "low"
- Recurring denial causes reported back so the upstream process — coding, scheduling, VOB — can be corrected at the source
Rules change by specialty — so does our approach.
AR & Denial Management looks different depending on what you bill. A few specialties where this shows up most:
Works inside the systems you already use.
AR follow-up and appeal tracking work directly against the claim data in your existing EHR or practice management system — including AdvancedMD, Tebra, athenahealth, eClinicalWorks, DrChrono, NextGen, and Epic — so there's a single, consistent record of what was billed, denied, and resolved.
AR & Denial Management, answered.
We start by mapping the full aging report, including balances well past 90 days, and prioritize based on likelihood of recovery and remaining appeal windows — we don't just focus on the newest, easiest claims.
Appeals and resubmissions are part of standard AR and denial management, not billed as a separate line item.
Based on the appeal window, the strength of supporting documentation, and the balance involved. We flag genuinely uncollectible balances rather than working them indefinitely, but we don't write off anything that has a real path to recovery.
Yes. AR and denial management can run as a standalone service on top of your existing billing process, or as part of full RCM.
Explore the rest of the revenue cycle.
Stop letting aging AR quietly become a write-off.
We'll review your current AR aging and denial patterns to show what's actually recoverable.