BLOG • Feb 19, 2025
Unlocking Revenue Potential: Why CARC Codes Are Essential for Denial Management
RCM CARC
🟢 Accounts Receivable (A/R) Management Services
Maximizing Collections, Reducing Outstanding Balances
Lock in your revenue. We manage invoices, track balances, and drive collections—so you can stay focused on your patients while we handle the rest
Schedule a Call40Days
Average Days in A/R
92%
A/R Over 90 Days Resolution Rate
87%
Net Collection Rate
Overview
Optimized A/R Management for Improved Cash Flow
Effective A/R management is crucial for a healthy revenue cycle. Our timely follow-ups reduce aging balances, maximize reimbursements, and streamline collections. By leveraging proactive strategies and structured workflows, we help healthcare providers recover outstanding revenue faster and more efficiently.
A/R Analysis & Aging Reports
We conduct detailed A/R aging analysis, categorizing claims by 30, 60, 90, and 120+ days outstanding. Our reporting helps identify bottlenecks in collections and payer-specific delays, allowing for targeted recovery efforts.
Insurance Follow-Up & Claim Resolution
Our team actively follows up with commercial insurers, Medicare, Medicaid, and third-party payers to resolve unpaid claims. We address denials, pending claims, and COB issues, ensuring claims move swiftly through adjudication.
Denial Management & Appeals
We analyse denial patterns using CARC and RARC methods. Our structured appeal process includes resubmission, reconsideration requests, and Level 1 & Level 2 appeals, securing rightful reimbursements.
Patient Collections & Payment Plans
We assist patients with billing inquiries, balance resolution, and structured payment plans. Our approach ensures compliance with financial assistance policies and state regulations while improving self-pay collections.
Inadequate Debt Prevention & Recovery
Our early intervention strategies prevent accounts from becoming aged receivables. We coordinate with collection agencies and legal teams for overdue balances, ensuring compliant debt recovery practices.
Operations
Comprehensive A/R Recovery & Financial Optimization
We implement structured workflows, advanced tracking systems, and payer-specific strategies to enhance A/R collections and reduce financial risks for healthcare providers.
AR Workflow Optimization
We streamline claim follow-up, payment tracking, and denial resolution with structured workflows that ensure timely account resolution.
Automated Claim Follow-Up & Status Tracking
Through EDI 276/277 transactions, we monitor claim statuses in real time, ensuring faster resolution of outstanding claims.
Secondary & Tertiary Insurance Billing
We submit claims to secondary and tertiary payers, collecting all eligible reimbursements before balances are transferred to patient responsibility.
Compliance & Regulatory Adherence
We follow HIPAA, CMS, and payer-specific policies, ensuring compliance with Medicare timely filing limits, Medicaid reimbursement rules, and Fair Debt Collection Practices Act (FDCPA) guidelines.
Custom A/R Reports & Financial Forecasting
We provide customized dashboards, A/R aging trends, and revenue performance analytics, helping providers make data-driven decisions to improve financial health.
Testimonials
Client Success Stories
FAQ
Frequently asked questions
Once we have safely received your patient and encounter data, we code, review, and send claims to payers. We also manage appeals and denials, track payments, and provide frequent updates. Our procedure is designed to be effective and open.
Our qualified coders and billing specialists evaluate every claim stringently. We employ quality control procedures, coding audits, and cross-referencing with payer requirements to guarantee accuracy and lower the possibility of denials.
Our denial management team examines every refused claim to identify the underlying reason. We quickly fix any problems and submit claims again, and where needed, we collaborate with payers on appeals to ensure you get the most money back.
Our pricing policy is adaptable and customized to meet every customer's demands. Usually, we charge a set fee based on volume or a portion of collections. Contact us for a quote tailored to your clinic's particular needs.
Indeed. Our specialty is smooth transfers from internal procedures or other billing businesses. To guarantee that all data is moved safely, our staff will collaborate closely with you and offer training as required.
Resources
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