Service
Aged receivables are rarely one big problem. They are a few hundred small ones, each needing a phone call nobody has time to make, and every week they sit the odds of collection drop. Claims past 90 and 120 days need research, correction, and pressure applied in the right order. That is the work we take on.
0
Years in revenue cycle
48h
Claim filing window
30d
Target days to payment
HIPAA
Compliant by design
Not every open claim deserves the same effort. We sort your aging by dollar value, payer behavior, denial category, and — critically — remaining time before the appeal or timely filing window closes. Claims about to expire get worked first regardless of size, because an expired claim is a permanent write-off. High-value claims with a clear correctable defect come next. This sequencing is why a queue that looked unmovable starts producing recoveries within the first several weeks.
Payer denial codes describe a symptom, not a cause. A generic medical necessity denial can actually be a missing authorization number, a diagnosis that was never linked to the procedure, or a coverage determination applied to the wrong date of service. Our specialists verify eligibility as it stood on the service date, revalidate the CPT and ICD pairing and modifiers, check for clearinghouse edits that never cleared, and read the remittance detail before deciding what corrective action the claim actually needs.
An appeal that restates the claim gets denied again. Ours cite the specific payer policy or contract provision at issue, attach the operative note, order, or authorization record that supports the service, and follow the payer's own appeal format and deadline. Each submission is logged with its date, reference number, and expected response window, then followed up on schedule. When first-level review upholds the denial and the documentation supports us, we escalate rather than write off.
Recovery is only half the value. We categorize every denial by root cause — registration, eligibility, authorization, coding, documentation, or payer processing error — and report the ranking by both frequency and dollars. When one payer starts denying a code they paid last quarter, you hear about it while it is still a handful of claims. Fixing an upstream process removes the denial permanently; working the same denial repeatedly just pays us to do it again.
Process
Your full open A/R is pulled and ranked by aging bucket, balance, payer, denial type, and time remaining before filing or appeal deadlines close. Expiring claims move to the front.
Specialists verify coverage as of the service date, revalidate coding and modifiers, check clearinghouse and payer edits, and read remittance detail to establish the actual reason payment stalled.
Fixable claims are corrected and resubmitted. Wrongful denials get a documented appeal citing payer policy with supporting records attached. Unresponsive payers are escalated through representatives and provider relations.
Denials are grouped by root cause and reported with frequency and dollar impact, so you can fix the upstream process that produced them instead of reworking the same claims each month.
More services
WNL RCM verifies patient coverage, benefits, plan type, and prior authorization before the visit, so claims go out payable and denials never reach your A/R.
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End-to-end medical billing from WNL RCM: daily charge entry, claim scrubbing, filing within 48 hours, payment posting, patient statements, and denial appeals.
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Certified coders assign accurate CPT, ICD-10, and HCPCS codes with NCCI edit checks, E&M leveling, and documentation queries that cut denials and audit risk.
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WNL RCM manages payer enrollment, CAQH and NPI upkeep, re-credentialing deadlines, and contracting so your providers get in network and stay billable.
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Clear credit balance backlogs with WNL RCM: reconcile true overpayments, correct misapplied postings, process compliant refunds, and document every action.
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FAQ
As far back as claims remain collectible. We check each aged account against the payer's timely filing and appeal deadlines and work everything still within a window, prioritizing by what expires soonest. Accounts genuinely past every deadline are identified and reported so you can close them cleanly rather than carry them.
Both. Status calls resolve claims that are simply sitting, but a denied claim needs a written appeal citing the applicable payer policy with supporting documentation attached. We prepare and submit those, track the response deadline, and escalate to second-level review when the first decision is wrong and the record supports us.
Typically within the first several weeks, because triage puts the most correctable high-value claims first. The pace after that depends on your payer mix and how much of the backlog needs documentation from your side. We report progress by aging bucket so you can see what moved rather than relying on a summary total.
Yes. A/R cleanup is a common standalone engagement. We work your aged inventory in your system while your existing billing continues undisturbed, which also produces a clear read on which denial causes originate upstream. Many practices start here before deciding on anything broader.
Registration and eligibility errors, missing prior authorization, coding and modifier problems, and documentation that does not support the billed service. Most are preventable before submission, which is why we report denials by root cause rather than volume — the goal is to stop producing them, not to get faster at reworking them.
Next step
Send us your specialty, claim volume and current billing setup. We will come back with a proposal you can act on.
