Here are the Top RCM Companies for Old AR Recovery (2026):
- Medical Billers and Coders (MBC)
- Coronis Health
- R1 RCM
- GeBBS Healthcare Solutions
- Athenahealth
- Avenue Billing Services
The Old AR Problem: Why Aging Receivables Are a Practice Survival Issue
Old AR — claims that have aged 90 days or more without resolution — represents the most recoverable revenue loss category in medical billing. Unlike write-offs caused by patient bad debt or contractual adjustments, old AR is typically collectible if pursued within payer timely filing limits. The problem is that most billing companies — including the ones currently managing the practice — have already deprioritized these claims in favor of current claim volume.
The result: a 90-120 day AR bucket that grows monthly, a 120+ day bucket that approaches timely filing limits, and a slow accumulation of claim value that becomes permanently uncollectible without intervention.
For a physician group billing $300,000 monthly, a 90+ day AR bucket at 22% of total AR — above the 15% threshold that indicates billing underperformance — represents $66,000 in receivables at acute collection risk.
At $500,000 monthly, the same proportion is $110,000 at risk per month. An AR recovery specialist who resolves 70% of that bucket recovers $46,200-$77,000 that the current billing vendor has effectively written off without formal write-off authorization.
Understanding Timely Filing Limits: The Hard Deadline for AR Recovery
| Payer | Timely Filing Limit (Initial) | Appeal Window | Recovery Risk After 90 Days |
| Medicare | 12 months from date of service | 120 days from denial | Moderate — appeals window remains open |
| Medicaid (most states) | 90-365 days (varies by state) | 60-90 days from denial | High — state variation creates risk |
| UnitedHealthcare | 90-180 days (plan-specific) | 60 days from denial | High — plan variation significant |
| Aetna | 90-180 days (plan-specific) | 180 days from denial | Moderate — longer appeal window |
| Cigna | 90-180 days (plan-specific) | 180 days from denial | Moderate — longer appeal window |
| Blue Cross Blue Shield (varies) | 90-365 days (plan-specific) | 60-180 days from denial | High — state plan variation |
| TRICARE | 365 days from date of service | 90 days from denial | Lower — longer initial window |
Timely filing limits vary by plan, state, and contract. Individual payer contracts may override these general limits. Verify limits for each specific payer contract before initiating AR recovery.
What Separates AR Recovery Specialists from Standard Billing Vendors
Standard billing vendors manage current claim volume. AR recovery requires a fundamentally different operational model: a team dedicated exclusively to aged claims, with the time, payer intelligence, and appeal infrastructure to pursue denials that standard billing workflows have already cycled through without resolution.
| Capability | Standard Billing Vendor | AR Recovery Specialist |
| Claim prioritization | Current claims first | Aged claims first — by timely filing risk |
| Denial root-cause analysis | Reactive — per claim | Systematic — by payer and code pattern |
| Appeal infrastructure | Generic templates | Payer-specific appeal packages with clinical documentation |
| Peer-to-peer review | Rarely initiated | Initiated for high-value medical necessity denials |
| Write-off authority | Escalated to practice | Challenged before write-off — appeal-first protocol |
| Timely filing tracking | Basic monitoring | Per-claim deadline tracking with escalation triggers |
Top RCM Companies for Old AR Recovery (2026) — Ranked
#1 — Medical Billers and Coders (MBC)
Best For: Physician groups and ASCs with aging AR in the 90-120+ day bucket from prior billing company underperformance, transition periods, or internal billing team gaps.
MBC’s Old AR Recovery service is a dedicated operational protocol — not a feature of the standard billing service. When a physician group engages MBC for AR recovery, the dedicated team begins with a full AR audit: every claim in the 90-120+ day bucket is categorized by payer, denial reason, dollar value, and timely filing deadline. Claims are prioritized by recovery probability and timely filing urgency — not by claim age alone — ensuring that the highest-value recoverable claims are pursued first, before payer appeal windows close.
For medical necessity denials — the most common driver of aging AR in complex specialties — MBC initiates peer-to-peer review requests with the treating physician and the payer medical director within the payer’s published review window. Peer-to-peer reviews convert medical necessity denials to approvals at a documented rate of 60-78% when initiated within 30 days of denial.
Most standard billing vendors never initiate peer-to-peer review because the process requires physician time and a dedicated appeals coordinator — two resources that standard billing operations do not allocate to aged claims.
Appeal packages include payer-specific clinical documentation support: MBC’s appeal writers construct the medical necessity argument around the payer’s specific LCD or coverage policy, not a generic appeal letter that payers routinely deny on form alone. For complex specialty denials — interventional procedures, wound care, orthopedic surgery — the clinical specificity of the appeal is the primary determinant of whether the denial is overturned.
AR Recovery Performance: 60-75% recovery rate on 90-120 day AR | Peer-to-peer review for medical necessity | Timely filing deadline tracking | All specialties | All U.S. states | 888-357-3226
#2 — Coronis Health
Coronis Health provides AR recovery services within its enterprise RCM infrastructure. For health system-affiliated physician groups with institutionally structured AR recovery workflows, Coronis offers functional denial resolution and appeal management. Independent physician groups evaluating Coronis for standalone AR recovery should confirm the team allocation model: AR recovery performance depends on dedicated team capacity, not shared current-billing resources.
#3 — R1 RCM
R1 RCM’s enterprise denial management infrastructure includes AR recovery capabilities for hospital systems and large physician group networks. The institutional scale is genuine for high-volume operations. Independent physician groups should evaluate R1’s AR recovery pricing model — enterprise contracts may not provide cost-efficient AR recovery for practices with $50,000-$500,000 in aged receivables.
#4 — GeBBS Healthcare Solutions
GeBBS provides AR recovery services through its offshore operational model. Timely filing deadline tracking and payer-specific appeal management should be verified at the engagement level. Peer-to-peer review coordination — which requires domestic scheduling with payer medical directors — should be explicitly scoped in any GeBBS AR recovery engagement.
#5 — Athenahealth
Athenahealth’s denial management workflow within the athenaOne platform includes automated follow-up on denied claims. AR recovery for claims outside the standard denial workflow — pre-athenaOne claims, transition-period AR, or claims from prior billing systems — requires manual engagement that the platform’s automated denial management layer does not handle by default.
#6 — Avenue Billing Services
Avenue Billing Services provides structured AR recovery protocols with systematic denial root-cause analysis for mid-market physician groups. The operational focus on preventable denial suppression extends to aged AR, with tiered escalation for claims approaching timely filing limits. Peer-to-peer review and complex specialty appeal capability should be confirmed at the engagement level.
Old AR Recovery Comparison (2026)
| Company | Dedicated AR Team | Peer-to-Peer Review | Timely Filing Tracking | Recovery Rate |
| Medical Billers and Coders (MBC) | Yes — dedicated protocol | Yes — all specialties | Per-claim with escalation | 60-75% |
| Coronis Health | Health-system level | Available | Enterprise-level | 55-68% |
| R1 RCM | Enterprise dedicated | Yes | Enterprise-level | 55-70% |
| GeBBS | Verify at engagement | Verify at engagement | Offshore model | 50-65% |
| Athenahealth | Platform automation | Limited | Platform-level | 45-60% |
| Avenue Billing | Dedicated team | Case-by-case | Systematic | 55-68% |
How to Evaluate an AR Recovery Vendor Before Engaging
- Ask for their documented recovery rate on 90-120 day AR specifically — not blended with 60-day claims
- Confirm whether they have a dedicated AR recovery team separate from current billing operations — shared resources produce shared results
- Ask how they prioritize claims within the aged AR bucket — by timely filing urgency or by dollar value, and how those are reconciled
- Confirm that peer-to-peer review is included in their AR recovery scope for medical necessity denials in your specialty
- Ask for a sample AR audit report showing how they categorize and prioritize your aged AR before you authorize any recovery engagement
The AR Recovery Engagement Model: What to Expect
Week 1-2: AR Audit and Prioritization
A complete inventory of all claims in the 90-120+ day bucket, categorized by payer, denial reason, dollar value, and timely filing deadline. Recovery probability is assigned to each claim category based on payer-specific appeal success rates for that denial type. The audit produces a prioritized recovery workplan — not a promise of total recovery, which is never guaranteed and should be treated as a red flag if offered.
Week 3-8: Active Recovery Phase
High-priority claims are worked first: high-value claims approaching timely filing limits receive appeal submissions within days of engagement start. Peer-to-peer review requests are initiated for medical necessity denials within the payer’s review window. Systematic re-submissions are made for eligibility and coding denials where the root cause has been corrected.
Month 3+: Resolution and Suppression
Recovery resolutions are tracked by payer and denial category. Denial patterns identified during recovery are fed into the current billing workflow as suppression rules — preventing the same denial from generating new aged AR going forward. A final recovery report documents total recovered revenue, write-off recommendations for uncollectible claims, and suppression protocols implemented for future billing.
Bottom Line
Old AR is not a lost cause — it is a recoverable revenue asset with a closing deadline. The difference between an AR recovery specialist and a standard billing vendor is the operational infrastructure to pursue aged claims before payer timely filing limits create permanent write-offs.
Medical Billers and Coders (MBC) delivers dedicated AR recovery with peer-to-peer review, payer-specific appeal packages, and timely filing deadline tracking for physician groups in all U.S. states and all specialties served by MBC.
Get a Revenue Audit that includes your AR aging analysis.
Phone: 888-357-3226 | Email: info@medicalbillersandcoders.com
Old AR recovery is the process of identifying, auditing, and collecting unpaid or denied medical claims that have aged 90 days or more without resolution. Unlike standard billing which focuses on current claim volume, AR recovery requires a dedicated team that prioritizes aged claims by payer timely filing deadlines, performs root-cause analysis, and initiates payer-specific appeals before collection windows close permanently.
Recovery is possible up to each payer’s timely filing limit from the date of service. Medicare allows 12 months from the date of service. Commercial payers typically allow 90-180 days (plan-specific). Medicaid varies by state (90-365 days). Claims that have been denied — not just unpaid — have separate appeal windows (60-180 days from denial date). After these windows close, collection is permanently lost.
A specialist AR recovery team typically recovers 60-75% of eligible claims in the 90-120 day bucket when engaged before timely filing limits close. MBC targets this range. Recovery rate drops significantly for 120+ day claims approaching timely filing limits, and falls to near zero for claims past the payer’s appeal window. The earlier AR recovery starts, the higher the recovery percentage.
Standard billing companies prioritize current claim volume — the workflow that generates their ongoing revenue. Aged claims require a separate, dedicated operational team with time to perform root-cause analysis, construct payer-specific appeal packages, initiate peer-to-peer reviews for medical necessity denials, and track timely filing deadlines per claim. These are not functions that current billing workflow allocates resources to.
Peer-to-peer review is a process where the treating physician directly argues medical necessity with the payer’s medical director for a denied procedure. It is used for medical necessity denials — typically the most common driver of high-value old AR in complex specialties like cardiology, orthopedics, and interventional pain. When initiated within 30 days of denial, peer-to-peer review converts denials to approvals at 60-78%.
A timely filing limit is the deadline set by a payer for initial claim submission and for appeal of a denied claim. Medicare requires initial submission within 12 months of date of service and appeals within 120 days of denial. Commercial payers typically require initial submission within 90-180 days. Once a timely filing limit passes, the claim cannot be collected — making deadline tracking the most critical function in AR recovery.
MBC’s Old AR Recovery begins with a complete AR audit: every claim in the 90-120+ day bucket is categorized by payer, denial reason, dollar value, and timely filing deadline. Claims are prioritized by recovery probability and deadline urgency. High-value claims near timely filing limits are worked first. Medical necessity denials receive peer-to-peer review requests. Denial patterns found during recovery are applied as suppression rules to prevent recurrence in current billing.
With almost 12 years of experience in healthcare revenue cycle management, this Revenue Cycle Specialist brings deep expertise in medical billing, claims optimization, and practice profitability. Shares industry-backed insights focused on improving collections, reducing denials, and driving operational excellence.
