Aged AR Cleanup for Independent Practices
A fixed-scope project for the claims past 90 days: every one worked to a final outcome, inside the EHR you already use.
- 12 to 15% of what we recover
- 30+ EHR integrations, no migration
- Free RCM audit in 3 to 5 business days
Scope
What a cleanup project covers
An aged AR cleanup is a one-time project with a fixed scope: every claim past 90 days that still carries a payer balance on a chosen date, worked until each one reaches a final outcome. It is one part of AR recovery for independent practices, run as a project with a start date, a frozen list and a closeout.
Claims past 90, 120 and 180 days with a payer balance
Every open insurance balance in the older aging buckets, sorted by payer and by bucket, so the oldest and most time-sensitive claims are visible before any work starts.
Rejections never corrected
Claims the clearinghouse or payer sent back and nobody fixed. Because they were never accepted, the payer never made a decision on them, and they can sit for months without ever showing up as denials.
Denials never appealed
Claims the payer decided and denied, where nobody checked whether the denial was correct or whether a corrected claim or appeal was still possible.
Claims with no payer response at all
Claims that went out and then went quiet: no payment, no denial, no remittance. Each one is checked with the payer to confirm it was received and where it stands.
Handled elsewhere
- Claims created after the snapshot date belong to ongoing follow-up. See how to keep new claims from aging.
- AR left in a system you have retired, or by a former billing vendor, is handled as a separate legacy runout. See what happens to AR a former billing company leaves behind.
- Appeal steps and denial codes are covered separately. If you are unsure whether denials are being worked at all, check whether your billing company is working your denials.
Project
How a cleanup project runs
Five phases. Each one ends with something you can hold us to.
- 01
Snapshot
The inventory is frozen at a date: every open claim past 90 days, listed by payer and by aging bucket. That list is the project scope, and it does not grow. Claims created after the snapshot stay with your team.
Deliverable: Frozen inventory list
- 02
Deadline triage
Every claim is placed in one of three states, explained in the next section. Claims past every window go to write-off review instead of the work queue, so hours go to claims that can still pay. You can check which claims are still inside a window yourself before we start.
Deliverable: Every claim assigned a state
- 03
Root-cause batches
Claims are grouped by the error that stalled them and fixed as a batch rather than one at a time. A single coordination of benefits correction, one payer-entity fix or one corrected member ID can clear many claims at once.
Deliverable: Batches with a named cause
- 04
Payer work to a final outcome
Every claim ends in one of four ways: paid, corrected and resubmitted, appealed, or written off with a documented reason. No claim leaves the project as "still pending, check later."
Deliverable: An outcome recorded per claim
- 05
Closeout
A report of what was recovered, what was written off and why, and which root causes are still producing new rejections at the front of the practice. The same results are visible in Apex while the project runs.
Deliverable: Closeout report
Timing, one engagement
In one engagement, the bulk of payment arrived within 45 to 50 working days of the start.
Individual results vary. Duration depends on inventory size and payer response times. One engagement is not a forecast.
Triage
The three states every aged claim is in
Before anyone works an aged claim, the question is which deadline still applies to it. Every claim in a cleanup falls into one of three states. Medicare is the worked example here because its rules are published in federal regulation.
Inside a filing window
For Medicare, a claim must be filed within 12 months of the date of service (42 CFR 424.44). A claim still inside that window is fixed and submitted as a clean claim.
Fix and submitPast filing, inside an appeal or reopening window
A Medicare redetermination must be requested within 120 days of receiving the initial determination (42 CFR 405.942). A reopening for any reason can be requested within 1 year of the initial determination (42 CFR 405.980).
Appeal or reopenPast every window
Usually a write-off. The exception is a claim where you hold proof of timely submission, which can reopen a path that otherwise looks closed.
Write-off reviewCommercial filing windows are set by each payer contract and can be far shorter than Medicare's.
For the reasons claims drift into these states, see why claims age past 90 days.
Last checked: September 24, 2026
Comparison
Before and after working with Quilven
This compares how a backlog looks before a cleanup with how it is handled during one. It describes process, drawn from one engagement, and is not a promise of outcome.
| Area | Before | With Quilven |
|---|---|---|
| Rejection ownership | Rejections pile up in a queue nobody is assigned to. A year passes. | Every rejection in the backlog is assigned, worked and closed with a recorded outcome. |
| Coordination of benefits | The same COB denial repeats across dozens of aged claims. | COB is fixed once with the patient, then every affected claim is resubmitted together. |
| Payer routing | Aged claims sit with the parent payer when a subsidiary with its own claims department owns them. | The right payer entity is confirmed, then the batch is resubmitted there. |
| Eligibility | Claims went out after coverage ended and were never redirected. | Terminated coverage is caught in triage. The claim goes to the active payer or to write-off review. |
| Member and group IDs | One bad ID repeats across months of claims. | The ID is corrected at the source record, then every claim carrying it is resubmitted. |
| Lab claim attribution | Group NPI in box 17 and a CLIA level mismatch, repeated across the backlog. | Rendering physician's NPI in box 17, CLIA level matched to the code, corrected as a batch. |
| Modifiers | QW missing on CLIA-waived codes, 25, 59 or RT missing where they apply. | Corrected by code family across every affected claim. |
| Timely filing | Nobody knows which aged claims are still inside a window. | Every claim is triaged against its payer's deadline before work starts, and proof of submission is kept. |
Not sure which of these sits in your backlog? See which claims are still workable.
Evidence
What happened to 245 aged claims
One AR recovery engagement. A family medicine practice in Minnesota. Individual results vary. One engagement is not a forecast.
The backlog
The project scope was 245 claims. Nobody had touched the rejections on the account for close to a year, and 75 claims had aged past 180 days.
The unworked rejection queue alone held roughly $40,000 to $50,000 in billed charges. That is the size of what was found in the queue, measured in billed charges, before any work began.
How it was triaged
The error types that kept repeating became a checklist. Claims were then ordered by how recoverable each one still was against its filing deadline. Each payer was called to learn the actual reason behind a denial, the correct payer for each patient was confirmed, and corrected claims went back out.
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.
What the deadline closed
On most of the affected UnitedHealthcare claims, the payer's 90-day timely filing window had already passed, and the practice had no proof of timely submission on file. Appeals on those claims had no path to success.
Headline cause
70% of the denials started at the front desk.
Afterward
The practice kept its own biller and changed how its front desk handles patients before the visit.
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
A cleanup project is priced like the rest of AR recovery: 12 to 15 percent of what comes back, nothing on claims written off. Here is how AR recovery pricing works.
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.
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.
A cleanup backlog is worked inside your EHR's own claim history. Nothing is exported to another system.
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 (202) 490-9406 or info@quilven.com.
Fit
Who a cleanup project is for
- 01Your biller left, or has been stretched thin for months. See what to do if your biller just left.
- 02A year of rejections sits in a queue that nobody owned.
- 03A new office manager, or an audit, found the backlog.
- 04Your AR over 90 days sits well past the HFMA MAP Keys line of 10 percent of total receivables. You can put a dollar figure on the backlog first, or compare your aging buckets to benchmarks.
Not for
Practices whose aged AR is already under that line, and whose real problem is new claims going unworked. That calls for ongoing follow-up, not a one-time project.
Practices in Wyoming can also see AR recovery for Cheyenne practices.
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 about a cleanup project
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