Systematic Accounts Receivable Management & Aging Recovery.
Uncover stalled claims, compress aged receivables, and establish disciplined follow-up protocols across commercial, government, and self-pay aging buckets.
The Reality of Aging A/R in Medical Practices
Receivables do not age gracefully. The structural collectability of an adjudication balance degrades non-linearly over time due to silent payer stalls, lost documentation, and unyielding timely filing deadlines.
Silent Payer Stalls
Commercial carriers frequently hold clean claims without producing formal rejection notices. Left unprompted by programmatic electronic batch queries or portal verification, claims idle until initial response windows expire.
Unworked Rejections & Coordination
Secondary coordination-of-benefits (COB) requests and subtle clearinghouse-level edits drop off standard dashboards. When re-submission requires updated clinical documentation, internal teams often defer action to newly billed claims.
Timely Filing Expirations
Commercial timely filing can be as restrictive as 90 to 180 days from the date of service. Once this window closes without definitive proof of timely submission or an active appeal sequence, legitimate revenue becomes contractually unrecoverable.
The JORVUS A/R Recovery Workflow
We replace haphazard aging sweeps with a five-phase, algorithmic ledger progression. Every account is assigned a deterministic follow-up velocity until formal adjudication or remitted payment.
Stratification & Prioritization
Segmenting the ledger across payer groups, balance magnitudes, and granular aging buckets (0–30, 31–60, 61–90, 91–120, 120+).
High-Dollar Aging Triage
Targeted focus on high-yield claims approaching statutory timely filing thresholds to prevent permanent administrative write-offs.
Payer Follow-Up & Escalation
Direct telephonic liaison, clearinghouse EDI tracking, portal interrogation, and tier-two supervisor adjudication escalations.
Resolution & Line Matching
Overturning administrative stall rationales, acquiring electronic remittances (EOB/ERA), and posting exact line-item reimbursements.
Systematic Trend Reporting
Isolating chronic payer lag signatures and recurring claim scrubbing errors to update front-end intake and payer contract teams.
Comprehensive A/R Management Capabilities
Complete operational coverage for every segment of the healthcare receivable portfolio, ensuring full regulatory adherence and fiscal reconciliation.
Insurance Aging Management
Multi-payer operational rigor handling Commercial plans, Medicare Part B, Managed Medicaid, Workers’ Compensation, and Personal Injury Protection (PIP/No-Fault). Specialized expertise in state-mandated prompt-pay statutory limits.
- Government and commercial appeal packets
- Workers' Comp adjuster documentation tracking
- Automated payer re-filing compliance checks
Patient Balance & Self-Pay Support
Respectful, compliant billing communication that protects the provider-patient relationship. Clear balance breakdowns, transparent itemized statements, and structured payment plan arrangements aligned with CFPB regulations.
- Plain-language digital & mail statements
- Structured formal installment agreements
- HIPAA & TCPA compliant communication channels
Credit Balance & Refund Handling
Unreconciled credit balances introduce regulatory exposure under False Claims Act rules and CMS 60-day overpayment guidelines. We audit unallocated receipts, verify dual-insurance overpayments, and process documented refunds.
- CMS 60-day rule compliant workflows
- Root-cause cross-posting audit
- Payer takeback verification & offset mapping
Aged Receivables Diagnostic Console
| Claim ID | Payer / Carrier | Aging Bucket | Balance | Action Code & Operator Notes | Status |
|---|---|---|---|---|---|
| CLM-88341-A | BlueCross BlueShield | 61–90 Days | $1,420.00 | [TEL-ESC] Spoke w/ rep ID #4812. Claim held for medical records verification. Chart notes faxed to appeals queue; ref #AP-99214. | Pending Review |
| CLM-91022-C | Aetna Commercial | 91–120 Days | $3,850.00 | [SUP-OVT] Supervisor escalation completed. Initial timely filing denial overturned; electronic clearinghouse acceptance receipt validated. | Reprocessing |
| CLM-94451-F | UnitedHealthcare | 31–60 Days | $640.00 | [EDI-COR] Corrected subscriber member ID via Availity clearinghouse portal; auto-rebatched to clearinghouse gateway. | Re-submitted |
| CLM-76190-M | Medicare Part B (FL) | 120+ Days | $2,190.50 | [RED-DET] Formal Redetermination packet submitted with physician signature and treatment necessity timeline. | In Appeal (L1) |
The JORVUS Advantage
Traditional billing companies cherry-pick high-dollar claims and quietly dump balances under $150 into bulk write-off categories. JORVUS operates under radical operational visibility.
No Abandoned Balances
Small balances add up to substantial recurring practice margin. We apply automated clearinghouse batch workflows and direct portal submission so no legitimate receivable is written off without client authorization.
Full Operational Transparency
You maintain live access to working queues. You see exactly when our revenue specialists touched each claim, which payer representative was contacted, and the exact call reference number provided.
Work Inside Your System
We avoid disconnected external spreadsheets. Our specialists document notes, appeal tracking, and payment posts directly inside your PM/EHR software, keeping your institutional audit trail completely intact.
Frequently Asked Questions
Detailed technical answers on our aging recovery procedures, system access parameters, and workflow standards.
How does JORVUS prioritize which aged claims to investigate first?
How do you handle legacy A/R from our previous billing company or legacy EHR?
What protocols do you have in place to prevent claims from reaching timely filing deadlines?
Does JORVUS work directly inside our existing software or via external files?
Reclaim trapped cash flow and bring transparency to your practice receivables.
Request an unbiased review of your aging ledger. We will identify unworked balances, diagnose stalled claims, and present an actionable liquidation plan.