Accounts Receivable Management for Healthcare Practices
Maximum Billing, LLC provides accounts receivable management for medical, behavioral health and dental practices. Aging is worked on a schedule by bucket and by payer, not whenever somebody finds an afternoon — because the money in a 120-day bucket does not wait politely while the front desk catches up.
We have specialized in mental health and dental billing since 2018, backed by more than 20 years in insurance billing and revenue management. We are based in Fort Myers, Florida, and bill for practices in Florida, Texas and elsewhere.
What We Handle
- Scheduled follow-up on every aging bucket, by payer and by dollar value
- Rejections corrected and resubmitted before they age
- Denials categorized by reason, appealed, and fed back upstream so they stop recurring
- Payment posting reconciled against your contracted fee schedule
- Underpayments identified rather than posted as paid
- Timely filing and appeal deadlines tracked per payer
- Patient balances, statements and payment arrangements
- Aging reports you can actually read, sent on a schedule
What Healthcare Accounts Receivable Actually Is
Accounts receivable in healthcare is every dollar you have earned and not yet collected — insurance claims sitting in adjudication, claims that were denied and never reworked, underpayments nobody caught, and patient balances left after insurance paid its share.
It is measured in two ways that matter. Days in A/R tells you how long your money takes to arrive on average. Aging buckets — 0 to 30 days, 31 to 60, 61 to 90, 91 to 120, and over 120 — tell you where it is stuck. The average alone hides the problem; a practice can post a respectable days-in-A/R figure while a growing pile sits past 120 days, quietly turning into a write-off.
Medical accounts receivable and dental accounts receivable behave differently, and behavioral health differs again. Dental carries more patient responsibility and more downgrades. Behavioral health carries authorization limits and carve-outs. The aging report looks similar in all three; what is causing it does not.
Why A/R Goes Bad Quietly
Very little of this is dramatic. Aging grows through ordinary omissions, repeated.
- A rejection never reaches anyone because it stopped at the clearinghouse
- A denial is filed rather than worked, because working it takes forty minutes
- An underpayment posts as a payment, because nobody compares it to the contract
- A claim needs a corrected submission and gets resubmitted unchanged, twice
- Patient balances accumulate because statements went out and nothing followed them
- Staff turnover, and the aging report loses its owner entirely
The common thread is that none of these announce themselves. Revenue does not drop the month it breaks; it drops two quarters later, and by then the oldest claims are past appeal.
How We Work an Aging Report
We work aging by priority rather than top to bottom. Claims still inside timely filing come first, because those are recoverable. Within that, we sort by payer and by dollar value, so one problematic payer is addressed as a pattern instead of one claim at a time.
Everything gets a reason code. If forty claims from one payer are denied for the same missing element, that is not forty phone calls — it is one workflow fix at the front of the process and a batch of corrected claims behind it. This is the part most billing arrangements skip, and it is the only part that stops the aging from rebuilding after it is cleaned up. Read more on claims denial management.
Timely Filing Is the Deadline That Ends the Conversation
Every payer sets a window for initial claim submission, and the range is wide — some commercial plans allow 90 days, others 180 or a year; Medicare allows 12 months from the date of service. Miss it and the claim is not denied so much as closed. There is no appeal for a claim that was never timely.
Appeal deadlines are separate and usually shorter, running from the date of the remittance rather than the date of service. A practice that discovers a denial 90 days late has often lost the appeal window even though the claim itself was filed on time.
We track both per payer. When we take over an aged backlog, the first thing we tell you is which claims are still inside these windows and which are not — honestly, including the ones that are gone.
Denials Versus Rejections, and Why the Difference Matters
These get used interchangeably and they are not the same thing.
A rejection never entered adjudication. It failed a front-end edit at the clearinghouse or the payer — a format problem, a missing identifier, an eligibility mismatch. It is not on the payer’s books at all, which means it will never appear on a remittance and will sit invisible unless someone is watching the clearinghouse reports. It can usually be corrected and resubmitted without an appeal.
A denial was adjudicated and refused. It has a reason code, it appears on the remittance, and fixing it means either a corrected claim or a formal appeal within the payer’s window.
Practices lose more money to rejections than denials, precisely because rejections are silent. Nobody appeals a claim they never knew failed.
What Actually Moves a Stuck Claim
Following up on a claim is not the same as checking its status. A status check tells you the claim is pending; follow-up establishes why, and what has to happen next.
Payer portals answer the easy questions fastest and should be the first stop — status, remittance detail, claim history. But portals routinely show a claim as received while giving no reason it has not moved, and at that point only a representative can tell you whether it is sitting behind a medical records request, an eligibility discrepancy, or a coordination of benefits question the patient never answered.
Every call gets a reference number and a note: who we spoke to, what they said, and what they committed to. That record is what makes an escalation possible. Without it, the second call starts from zero and the payer’s clock keeps running.
The claims that need this treatment are a minority. The discipline is in identifying which ones they are quickly, rather than spending an afternoon on a $40 claim while a $1,800 claim ages past appeal.
Patient Balances and Statements
Patient responsibility has grown into a large share of collections, and it is the part of accounts receivable most practices handle worst — not from unwillingness, but because chasing balances is uncomfortable and always less urgent than the patient in front of you.
The work that actually collects patient balances starts before the visit. Accurate eligibility and benefit verification means the estimate you give the patient is close to the real number, and a patient who was told the right figure in advance pays far more reliably than one surprised by a statement six weeks later.
After that it is a process, not a reminder: statements on a predictable cycle, a clear explanation of what insurance paid and what it did not, payment arrangements for larger balances, and consistent follow-up. For self-pay and uninsured patients, a written good faith estimate is both a legal expectation and the single best predictor of whether the balance gets paid.
We handle statements, balance follow-up and payment arrangements as part of accounts receivable management rather than as an afterthought bolted on at the end.
The Numbers We Report
You should be able to see whether your receivables are healthy without commissioning a report.
- Days in accounts receivable — the average age of what you are owed
- Aging buckets — the share sitting past 60, 90 and 120 days
- Clean claim rate — the share paid on first submission
- Net collection rate — what you collected against what you were contractually owed, which is the number that exposes underpayments
- Denial rate by reason and payer — the number that tells you what to fix
- Patient balance aging — tracked separately, because it behaves nothing like insurance A/R
Taking Over an Existing Backlog
Most practices come to us with aging already built up, often after a staffing gap or a system change. That is a normal starting point and we treat it as its own project rather than folding it into routine work.
We triage the backlog first: what is inside timely filing, what is inside appeal windows, what is genuinely uncollectible, and what is worth the labor to pursue. Then we work it in priority order while current claims continue going out clean, so the backlog shrinks instead of simply moving.
You will get a straight answer about what is recoverable. A billing company that promises to collect all of it has not looked at the dates.
Frequently Asked Questions
What is a healthy days in A/R?
It varies by specialty and payer mix, but most practices should be looking for a figure in the 30 to 40 day range, with very little sitting past 120 days. The trend matters more than the absolute number — a figure that is climbing month over month is the signal.
Can you work our old aging, not just new claims?
Yes, and it is a common reason practices call. We triage it by what is still inside timely filing and appeal windows, then work it in priority order.
Will you tell us what is not collectible?
Yes. Claims past timely filing with no appeal route are gone, and pretending otherwise wastes your money and our time. You will get that list.
Do you handle patient balances as well as insurance?
Yes. Statements, balance follow-up and payment arrangements are part of the service, and patient balance aging is tracked separately from insurance aging.
How do you find underpayments?
By reconciling payments against your contracted fee schedule rather than posting whatever arrives. An underpaid claim looks exactly like a paid claim until someone compares the two.
Do you work inside our system?
Usually, yes. We work in your practice management system or EHR where possible, which keeps your data where it already lives — see our HIPAA compliant billing services.
If your aging report has a growing tail past 120 days, or nobody can say what your net collection rate is, those are both fixable. Contact Maximum Billing, LLC or call 800-820-0364. See also our medical billing services for Florida practices, and our dental billing services.