AR Recovery Services for Independent Practices
We work the claims your team stopped having time for, inside the EHR you already use, and we are paid on what comes back.
- 12 to 15% of what we recover
- 30+ EHR integrations, no migration
- Free RCM audit in 3 to 5 business days
In plain terms
AR recovery, stated plainly
- Quilven provides AR recovery services to independent medical practices.
- AR recovery works aged, rejected, underpaid and unsubmitted claims.
- Quilven charges 12 to 15 percent of the amount recovered.
- Quilven integrates with 30+ EHR and practice management systems.
- The free RCM audit returns a recoverable revenue estimate by payer in 3 to 5 business days.
- Timely filing deadlines determine whether an aged claim is still recoverable.
- Front desk eligibility and COB capture causes most preventable claim denials.
- Apex reports net collection rate, AR aging by bucket and denial reasons by payer.
- Quilven differs from a collection agency, because it works the insurance side, not bad debt.
Scope
What we work
Unpaid claims still inside filing windows
These are claims that were submitted, rejected or ignored, and never touched again. The window to correct and resubmit is still open, but nobody is watching the rejection queue, so the balance sits in the tracker looking like revenue when it is really a countdown. This is the highest-value inventory in most practices because the work is clerical and the deadline has not closed yet.
Claims aged past 90 and 120 days
Older inventory stalls for a different reason. The original error is no longer obvious, the staff who submitted the claim may be gone, and each account needs a payer call before it can move. Work here is triage before it is follow-up, and before you commit to anything you can estimate what your aged AR is still worth. When the backlog is big enough to need its own project, it is run as an aged AR cleanup.
Claims paid below the contracted rate
A partially paid claim closes quietly. It shows as adjudicated, the balance is written off or left as a rounding error, and nobody compares the remittance against the fee schedule. Underpayments repeat by code and by payer, so the same silent shortfall runs every month until somebody reconciles it.
Patient balances
Patient responsibility grows with deductible plans, and it ages faster than insurance AR because statements stop after the second or third cycle. These balances need a defined cadence rather than one-off collection pushes, which is equally true of ongoing claim follow-up on the insurance side.
Method
How the engagement runs
- 01
Inventory and aging analysis
Every claim in the tracker is pulled and sorted twice, once by aging bucket and once by payer. Before anything is worked we want to know how much of the inventory sits past 90 days, which payer holds it, and how much of it is unworked rejections rather than open claims. Practices are usually surprised by the split.
- 02
Root cause sort
We read the inventory for repeating error types and build a checklist from them, instead of working claims one at a time. If coordination of benefits is stale on forty accounts, that is one fix applied forty times. This is also the part that tells you what to change at the front of the practice.
- 03
Prioritization
Each claim is scored on recoverability against its filing deadline. Claims worked within days of rejection are recoverable. Claims found a year later usually are not, and pretending otherwise burns hours that belong on collectible accounts. Deadlines drive the work order, not dollar size, and you can check how much time is left on each payer's filing window yourself in a minute.
- 04
Payer work
We call the payer for the real denial reason rather than trusting the remittance code, verify which payer entity the patient actually belongs to, correct the underlying field or modifier, and resubmit to the right claims department. One sentence on appeals: where an appeal is warranted, we file it with the documentation the payer actually asks for.
- 05
Posting and reporting
Payments post back into your system, and both the results and the root causes surface in Apex, so you see net collection rate, aging by bucket, and denial reasons by payer while the work is happening rather than in a monthly summary.
Comparison
Before and after working with Quilven
This is a process comparison drawn from one AR recovery engagement, not a promise of outcome. It shows what changes in how claims are handled, which is the part that carries from one practice to the next.
| Area | Before | With Quilven |
|---|---|---|
| Rejection ownership | Nobody owns the rejection queue. Claims reject, nobody catches it, six months to a year passes. | The rejection queue is worked within four to five days, while the claim is still recoverable. |
| Coordination of benefits | COB never updated because nobody calls the patient. The same claim denies again and again. | COB is resolved by contacting the patient, then the claim is resubmitted with current coverage. |
| Payer routing | Claims go to the parent payer when they belong to a subsidiary that runs its own claims department and its own member IDs. | The correct payer entity is verified before submission, not after the denial. |
| Eligibility | Coverage has terminated, the claim goes out anyway, nobody called for updated insurance. | Eligibility is verified before the visit, not after the denial. |
| Member and group IDs | A stray dash in a member ID sits in the system for a year. | Demographic fields are checked against the payer record before the claim goes out. |
| Lab claim attribution | The group NPI sits in box 17 where the individual physician's NPI belongs, and the CLIA level does not match. | The rendering physician's NPI is in box 17 and the CLIA level matches the code billed. |
| Modifiers | CLIA-waived lab codes submitted without QW. Missing 25, 59, RT where they apply. | A modifier check runs before submission, by code family. |
| Timely filing | Rejections surface a year later with no proof of timely submission on file, so the appeal cannot be won. | Filing deadlines are tracked per payer and proof of submission is retained. |
Which of these is costing you money is an answerable question. Get your recoverable revenue estimate.
Before and after, in feeling
What changes for the person holding the aging report
Frustrating now
The aging report grows every month and nobody has hours to work it.
Reassuring after
One party owns the inventory and reports on it weekly, so the number moves in one direction.
Anxious now
You suspect money has already been lost to closed filing windows and do not know how much.
Clear after
The audit separates what is still collectible from what is gone, in writing, by payer.
Resented now
Vendors who bill hourly whether or not a claim ever pays.
Fair after
A percentage of what actually lands, and nothing on what does not.
Exhausting now
Every proposal seems to end in a software migration and staff retraining.
Relieving after
Work happens inside the EHR you already use, with no migration and no workflow change.
Distrustful now
Promised recovery rates that nobody can support.
Honest after
No recovery rate promised, one labeled engagement shown, including what could not be recovered.
Benchmarks
What is realistically recoverable
Published benchmarks give you a way to judge your own aging before anyone quotes you a fee. The HFMA MAP Keys hold that AR over 90 days should stay under 10 percent of total receivables. The MGMA 2024 Cost and Revenue Survey reports a median of 47 days in AR across physician practices, and 36 days for better performers.
The same MGMA data shows better performers holding over 70 percent of receivables under 30 days, with 8.1 percent past 120 days, and you can compare your own aging against those benchmarks. Revecore reports that collection rates on accounts over 90 days drop as low as 50 percent, which is the honest shape of aged inventory: the balance is real, the collectible portion of it is smaller than the report says.
Some balances are simply not recoverable. A closed filing window with no proof of submission is not a collections problem, it is a closed door, and no vendor should tell you otherwise. What an audit does is separate the two, so you spend effort where money still moves. Separately, we cover why your AR over 90 days keeps climbing.
We do not quote a recovery rate, because the number depends on your payer mix, the age of your inventory, and whether the original submissions can be proven. Benchmarks tell you whether you have a problem. Only the claims tell you how much of it is money.
Evidence
One AR recovery engagement, in detail
One AR recovery engagement. A family medicine practice in Minnesota. Individual results vary. One engagement is not a forecast.
The situation
245 claims were in scope. Rejections had gone unworked for roughly a year, and 75 of those claims were sitting in the 180+ day bucket. Roughly $40,000 to $50,000 in billed charges was sitting unworked in the rejection queue. That figure is what was found sitting there. It is not what was recovered.
What was found
Six root causes repeated across the inventory, shown here unweighted because only the front-desk share was measured:
- —Coordination of benefits never updated
- —Member ID and demographic errors
- —Claims routed to the wrong payer inside a payer umbrella
- —Coverage terminated with claims submitted anyway
- —CLIA level mismatch with the group NPI in box 17 instead of the physician's
- —Missing modifiers, including QW on CLIA-waived codes
70% of denials originated at the front desk
Not in coding. Not with the payer. Eligibility, coverage verification, coordination of benefits, and demographic capture.
What was done
Every claim in the tracker was reviewed. A checklist was built from the repeating error types rather than working the claims one at a time. Payers were called for the real denial reason. The patient's actual payer was verified. Corrected claims were resubmitted to the right entity.
What came back
$5,500
recovered (approximate)
50 to 55
claims paid
45 to 50
working days to the bulk of payment
245
claims in scope
Individual results vary. One engagement is not a forecast.
Blue Cross Blue Shield was the source of nearly all of the recovery. The single largest item was roughly $700 on a pediatric immunization claim that had been sitting about a year.
Payer mix on the account, largest first:
- Blue Cross Blue Shield
- Medica
- Minnesota Medicare
- UnitedHealthcare and Surest
- Medicaid
- Cigna, at about 2 percent
What could not be recovered
UnitedHealthcare's 90-day timely filing window had closed on most of the affected claims, and there was no proof of timely submission on file, so those appeals could not be won. Claims worked within four to five days of rejection are recoverable. Claims found a year later usually are not. That is the difference between an AR problem you can fix and a loss you can only stop repeating.
What the practice did next
The practice kept its in-house biller and fixed its front desk. It now verifies eligibility with software before the patient arrives, stopped taking walk-ins, verifies every patient the night before, and its biller learned directly from the biller on the account which mistakes to stop making.
This was an AR recovery engagement and an audit, not an ongoing billing relationship. The practice chose to act on the diagnosis itself.
In their words
What the physician said
What you have provided for me was a detailed of things that are going wrong that needed to change in our practice.
I appreciate that you did an audit and found out the root causes of a lot of my problems which are preventable.
I appreciate the professionalism, the courtesy, the knowledge.
After the audit the practice changed how it runs: eligibility verified before arrival, no more walk-ins, every patient checked the night before.
Pricing
What AR recovery costs
AR recovery
12 to 15%
of the recovered amount
No fee on what is not recovered. Where a practice lands in the range depends on claim volume, age of the inventory, and payer mix.
Medical billing
3 to 5%
of collections by monthly volume
A $500 monthly minimum applies. The rate moves with monthly volume, not with headcount on your side.
Credentialing
$150 to $250
per provider per payer
Priced per enrollment so you can see exactly what each payer application costs before it starts.
Hourly rates and per-seat staffing bill you for effort whether or not a claim ever pays, while a percentage of recovery only earns when the money lands in your account. See how every Quilven service is priced, or book a line-by-line audit and get a number specific to your inventory.
Fit
Fit with your EHR
Recovery work does not require a system swap. We integrate with 30+ EHRs and practice management systems and work inside the one you already have. No data migration, no parallel system, no change to how your staff enters a charge or checks a patient in. If your team is trained on your current software, that training stays valid.
This matters because the usual objection to outside AR help is that it turns into an implementation project. It does not here. Quilven is a managed service, not software. There is no proprietary platform you are asked to adopt and no license to renew, so the engagement can start on your existing inventory rather than after a build-out.
What you do get is visibility. Apex is our client dashboard, and it shows in real time:
- Net collection rate
- AR aging by bucket
- Denial reasons by payer
- Credentialing pipeline
Apex reads the work we are doing in your system. It is a window, not a replacement, so if the engagement ends your records and workflows are exactly where they were.
Company
Who Quilven is
Quilven is a managed revenue cycle service. Not software, not an EHR, and not a proprietary platform you have to adopt. We work inside the system your practice already uses, across 30+ integrations, with no data migration and no workflow change. Our clients are independent practices with 3 to 25+ providers.
Pricing is straightforward. AR recovery is 12 to 15 percent of the recovered amount. Medical billing is 3 to 5 percent of collections by monthly volume, with a $500 monthly minimum. Credentialing is $150 to $250 per provider per payer.
The entry point is a free RCM audit. It takes 3 to 5 business days and returns a line-by-line recoverable revenue estimate by payer, so the first thing you get from us is a diagnosis you can act on with or without us.
We lead with method and evidence rather than tenure. Quilven was founded in 2025 by Raief Shick and works from 159 4th Ave N, Suite 100, Nashville, TN 37219. The entity is registered in Wyoming. Reach us at (855) 895-7721 or info@quilven.com.
Fit
Who this is for
This is built for independent, physician-owned practices with 3 to 25+ providers, where billing is handled by one or two people who are already at capacity and the aged inventory has quietly become somebody's third priority. If your rejection queue has claims older than a quarter in it, the work described here is the work you need.
It is not a fit for everyone. If your AR over 90 days is already under 10 percent and your rejections are worked within a week, an outside recovery engagement will not find enough to be worth your time, and we will say so after the audit instead of selling you a retainer.
Coverage spans the range of ambulatory work, from primary care through procedural specialties.
At a glance
AR recovery service facts
- Service
- Managed AR recovery for independent medical practices
- Service type
- Accounts receivable recovery and denial root-cause correction
- Delivery model
- Managed service, not software, not an EHR
- Systems
- 30+ EHR and practice management integrations, no data migration
- Practice size served
- 3 to 25+ providers, independent and physician-owned
- Inventory worked
- Unpaid claims in filing window, claims past 90 and 120 days, underpayments, patient balances
- Pricing
- 12 to 15 percent of the recovered amount, no fee on what is not recovered
- Entry point
- Free RCM audit, 3 to 5 business days, recoverable estimate by payer
- Reporting
- Apex dashboard: net collection rate, AR aging by bucket, denial reasons by payer, credentialing pipeline
- Area served
- United States
- Data handling
- Aging totals only to start, no patient data required
FAQ
Questions practices ask first
Next step
Start with a free RCM audit
The audit takes 3 to 5 business days and returns a line-by-line recoverable revenue estimate by payer, plus the repeating root causes behind your denials. We only need aging totals to begin. No patient data, no contract, no obligation to work with us afterward. If your aging is healthy we will tell you that.
Where is the money leaking right now?
Pick the one that hurts most. We start there.
How old is your oldest unpaid claim?
A round number is fine. We verify it in the audit.
How big is the practice?
Just you, or a group. Either is welcome.
Last bit — where do we send the report?
No patient data. We only need aging totals to start.
(202) 490-9406 · info@quilven.com · Book 15 minutes