Case Study: Recovering $90K in Aged AR for a Podiatry Practice

The situation

A growing podiatry practice came to us with accounts receivable that kept climbing, especially in the 90 day and older buckets. Cash flow was tight. Claims were being followed up every week, yet the balance was not coming down, which usually means the effort is aimed at the wrong layer of the problem.

The practice is anonymized here, and no patient or payer-specific details are shared.

How we approached it

We run aged AR recovery as a structured process, and this engagement followed it from start to finish.

1. Audit and segment. We pulled the full aging report, reconciled it against payer remittances (ERA and EOB), and grouped every open claim by why it was unpaid: denial, no response, underpayment, eligibility or authorization, or payer setup. This step separates real recovery work from repeated follow-up on claims that will not move.
2. Prioritize. Claims were ranked by balance, payer and the time left before filing or appeal limits, so the highest-value and most time-sensitive accounts were handled first.
3. Assign an owner and a next step. Every claim had a named owner, a defined action and a follow-up date. Claims that stalled for payer-setup reasons were routed to our credentialing department, and the rest stayed with billing.
4. Resolve by cause. Denials were appealed with supporting documentation, claims with errors were corrected and resubmitted, claims with no payer response were escalated through provider relations, and underpayments were compared against the contracted rate and disputed.
5. Post, reconcile and close. Payments and adjustments were posted and reconciled, so each account ended with a documented final outcome: paid, adjusted, or closed after a confirmed payer decision.
6. Report weekly. The practice received a weekly summary of cash collected, claims resolved and balances still open.
7. Fix the source. Where a cause kept repeating, we flagged it to the practice so it stopped creating new aged AR.

The result

The first $45,000 was collected within 40 days. Within 60 days, $90,000 in cash had been collected. Altogether, within the same 60 days, more than $200,000 in aged claims was resolved, with the difference between that figure and the cash collected closed out through contractual adjustments and a small number of write-offs, such as claims affected by a patient’s hospice status and a few that had passed their filing limits.

What this shows

Aged AR is rarely fixed by effort alone. It is fixed by knowing why each claim is stuck and putting it in front of the person who can resolve that specific problem. Sorting by cause, prioritizing by value and deadline, and tracking every claim to a final outcome is what turned a growing balance into collected cash. It is also why we report cash collected and total resolved as two separate numbers.