Receivable Recovery Services for ID Practices

Receivable recovery services help identify, pursue, and resolve unpaid or underpaid claims. For infectious disease practices, this may include aging A/R follow-up, payment reconciliation, denial analysis, appeals, rejection clearing, and revenue leakage review. The work can examine office visits, hospital consults, infusion, drug, and OPAT-related claims while also identifying process issues that allow balances to remain unresolved.

Revenue leakage can be identified by reviewing reporting across payers, service lines, and providers, then tracing missing revenue to its source. Common areas for review include documentation, coding, charge capture, contracts, authorization, drug billing, and administration charges. Comparing expected reimbursement with actual payment activity can also reveal recurring underpayments, missed charges, or claims that were never successfully pursued.

A/R follow-up may include infusion drug claims, hospital consult claims, complex outpatient visits, E/M claims, administration claims, and other infectious disease claims represented in the practice’s accounts receivable. Accounts can be organized by payer, service type, and balance so attention is directed toward unresolved items and patterns that may indicate broader workflow or payment problems.

Underpayment review compares actual payment activity with expected reimbursement for relevant drug, administration, and E/M claims. The review can flag short-pays, incorrect fee schedule application, unit mismatches, and NDC mismatches. Identified underpayments are then documented, disputed, and tracked to recovery, while recurring findings can inform payer discussions and internal billing improvements.

Yes. Denial management can group denials by root cause, such as drug and administration coding, missing authorization, medical-versus-pharmacy benefit confusion, or insufficient consult documentation. Payer-specific appeals can be supported with clinical documentation, while the findings are shared with clinical, coding, and front-office teams. This connects recovery work with process changes intended to reduce recurring denial patterns.

Yes. Support can be structured around a practice’s existing team and systems. Options may include focused A/R follow-up, denial and appeal work, payment reconciliation, rejection clearing, or overflow claims management. The broader goal is to address the areas where internal capacity, workflow complexity, or unfamiliarity with infectious disease billing may leave claims delayed or unresolved.

Useful starting information may include aging A/R reports, payer payment records, denial categories, claim and rejection information, service-line reporting, contract terms, and workflow details from referral through final payment. Reviewing these sources together helps distinguish isolated account issues from recurring problems involving documentation, authorization, coding, charge capture, reimbursement, or follow-up practices.

No. GrowInfectiousDisease does not publish invented rates, benchmarks, drug acquisition costs, payment rates, or margin figures. Its approach is to explain the financial mechanics, distinguish verified information from practice-specific figures, and allow practices to apply their own numbers through available tools and models. This supports analysis without implying that one practice’s assumptions apply universally.