Insurance A/R
Separate no-response claims, denials, underpayments, secondary coverage, and payer follow-up so each balance has a documented next action.
Patient and aged A/R recovery
Medical accounts receivable services that keep every balance moving
Integrity RCM helps independent practices separate insurance and patient-responsibility balances, verify what is actually due, and give each workable account a visible next action—without asking the front desk to become the follow-up department.
One aging total is not enough
Separate the balance before working the balance
Insurance and patient A/R require different evidence, communication, and escalation. The first step is to stop treating every open dollar as the same kind of work.
Patient responsibility
Verify copay, coinsurance, and deductible balances after available payer activity, then move accurate balances into the approved patient-billing workflow.
The recovery workflow
Turn aged balances into assigned, measurable work
Establish the baseline
Organize balances by insurance versus patient responsibility, age, value, status, system, and current owner.
Verify what is due
Review available remittance, adjustments, secondary coverage, posting status, statements, and unresolved exceptions before follow-up.
Assign the next action
Place every workable balance into a defined follow-up path with an owner, due date, contact outcome, and escalation point.
Report movement and leakage
Show what moved, what remains blocked, and which registration, coverage, posting, or workflow issues keep producing aged balances.
Reviewed operating evidence
Fast payment posting and persistence on older balances
In a reviewed six-month operating cohort, more than nine out of ten measurable net posted dollars arrived within 30 days of service. The same cohort included patient-responsibility payments tied to services more than 120 days old.
Payment-posting timing is not the same as days in A/R. Every practice begins with its own baseline, payer mix, and inherited balance inventory.
Fair performance measurement
Separate the current operating result from the inherited backlog
One blended aging percentage can hide strong insurance follow-through and make an older patient-balance process look like a current billing failure. Integrity defines the cutoff, responsibility type, and collectible amount before scoring the work.
Measure insurance follow-through
Age insurance balances from billed date, use an agreed operating start, and keep earlier balances visible as a separate recovery cohort.
Prevent new patient A/R
Measure copay, coinsurance, and deductible collection before the visit after the practice adopts its updated point-of-service workflow.
Recover the earlier patient backlog
Track accurate pre-policy balances as a fixed recovery population instead of blending them into the score for the newer workflow.
Use the collectible denominator
Compare payments with the contract-adjusted amount due from the payer and patient, not the practice’s higher undiscounted charge.
When to look closer
Signals that patient and aged A/R need a defined owner
- Patient balances are growing after insurance processes the claim.
- Staff cannot quickly separate insurance A/R from patient responsibility.
- Statements and reminders go out, but follow-up ownership is unclear.
- Copay, coinsurance, and deductible balances remain open without a next action.
- Secondary coverage, posting, returned-statement, or demographic exceptions stall work.
- Leadership sees a total balance but not the movement, barriers, or responsible owner.
A focused starting point
Review the smallest useful evidence set
- A current aging view separated by insurance and patient responsibility
- Available remittance, adjustment, payment-posting, and secondary-coverage status
- The practice’s statement, reminder, payment-plan, escalation, and write-off rules
- A list of systems and teams involved in billing, payments, and follow-up
A guided, view-only system review is preferred. De-identified reports remain a fallback when system access is unavailable or a dated baseline is needed.
Prepare an A/R reviewCommon questions
What the first conversation should clarify
How does an A/R review begin?
We start with a conversation and the practice’s existing systems. A temporary, named view-only user is the preferred review path when available. De-identified reports or an assisted export can be used when direct access is not practical.
Do we need to upload patient reports through this website?
No. Do not send patient information through the public website. Access, reports, retention, and security requirements are confirmed through an approved process before any real account review begins.
How is progress measured?
The practice and Integrity define a starting snapshot, aging buckets, balance types, exclusions, movement measures, and reporting cadence before results are compared. Unreviewed recovery amounts are never promised.
What kind of patient follow-up is included?
The workflow can organize statements, reminders, call tasks, payment-plan routing, contact outcomes, and unresolved exceptions according to the practice’s approved policies. Any separate outside placement requires its own scope and review.
Start with visibility
Find out what is collectible, blocked, or preventable
Define the starting A/R snapshot, review method, and ownership model before setting a recovery scope or making a financial projection.