A/R Follow-up and Appeals
A/R Follow-up and Appeals
A/R Follow-Up
Aged Claim Monitoring
Denial Categorization
Escalation & Resolution
Recover more revenue faster with our A/R Follow‑Up and Appeals service. Emerger RCM proactively manages outstanding claims, investigates denials, and executes effective appeals helping you close gaps in reimbursement and optimize cash flow.
A/R Follow-Up
Our A/R follow-up team monitors outstanding claims throughout the billing cycle. We track aged receivables in your PMS/EHR, identify delays in payer responses, and initiate timely follow-ups. When claims stall due to missing info or eligibility issues, we investigate directly with payers, address documentation gaps, and resubmit accurately.
With clear aging reports and personalized outreach scripts, our process accelerates payment, reduces your days in A/R, and improves your financial health all while keeping your team updated through daily dashboards.
Appeals Management
Our award-winning appeals management service tackles denied and underpaid claims with precision and tact. We categorize denials whether coding, medical necessity, or procedural and craft compelling appeal letters supported by clinical documentation. We submit appeals within payer guidelines and manage communications proactively, tracking each case until resolution. By combining expert knowledge of payer rules with thorough follow-up, we maximize reversal rates, boost payment recovery, and significantly lower write-offs, safeguarding your revenue stream.
Contact us today to learn more about our team
We would be happy to answer any questions you may have or provide you with additional information about our services.
Aged Claim Monitoring
Proactively tracks and flags claims that exceed payer response windows for timely follow-up.
Payer Inquiry & Investigation
Contact insurers directly to resolve missing info or delays and expedite payment.
Denial Categorization
Systematically classify denials by type and prioritize those with highest reimbursement potential.
Appeal Submission & Tracking
Submit appeals electronically or via paper, then monitor status until resolution.
Escalation & Resolution
Escalate stalled appeals or unresolved issues to payer management when necessary.
Appeal Letter Preparation
Draft well-supported appeal packets using compliant clinical and billing documentation.
We analyze your aged receivables by payer, denial type, and outstanding dollar value to create a prioritized workflow. High-value or high-probability claims are advanced first, ensuring the most impactful results. Our team reviews aging buckets, stages outreach at defined intervals (e.g., 30, 60, 90+ days), and allocates resources to claims with highest recovery potential.
This strategic focus helps reduce overall A/R days and enhances your cash flow, giving you visibility into performance metrics and ROI.
Our appeals specialists are well-versed in payer-specific guidelines and clinical documentation requirements. Using a case-by-case approach, we research the root cause, gather necessary medical records, physician notes, and correct coding edits. Every appeal is tailored whether it’s a first-level appeal or an escalation maximizing success.
We emphasize clarity and compliance, referencing relevant CPT/ICD codes and policy criteria. Regular status updates and transparent dashboards keep your team informed as we drive higher payment recovery rates.
When routine follow-up fails, our escalation process kicks in. We maintain a network of payer contacts and escalation protocols for deeper intervention via senior adjudicators or provider relations teams. Our structured escalation letters and documented call attempts demonstrate diligence, often unlocking payments stalled due to internal payer process failures.
We track escalations, report on outcomes, and use what we learn to prevent future issues. This robust escalation layer ensures your claims aren’t lost in the backlog.
Emerger’s reporting suite provides comprehensive insight into A/R trends, appeal outcomes, recovery rates, and outstanding balances by payer, service line, and provider. Monthly and real-time dashboards display key metrics such as days in A/R, appeal success rate, and recovered versus written-off dollars.
These reports allow your financial team to track progress against targets and identify high-risk areas. By quantifying recovered payments, our reporting proves the ROI of the A/R follow-up service and supports strategic financial planning.
Every practice operates differently, which is why we tailor our A/R and appeals workflows to fit your operational model. Whether integrated into your existing PMS alerts, EHR workflows, or managed via our portal, our team adapts to your processes. Extended-hour or shared-service models are available to match your call center and office hours.
We coordinate closely with your billing and clinical staff, aligning outreach efforts with internal follow-up schedules. This seamless partnership ensures consistency, minimal disruption, and improved reimbursement performance.
