Why is this claim still in AR-have you ever asked that during a revenue cycle meeting? If the answer is yes, you are not alone. Many practices like yours are seeing more and more revenue get stuck in AR, often for reasons that could have been avoided. In most cases, it is due to simple, preventable errors that slip through before the claim is even submitted.
Let’s discuss how healthcare accounts receivable services can help improve your first-pass resolution rate. If you are a practice administrator or physician trying to understand why your claims keep getting stuck, this piece is here to help you take control.
Where it all starts: the root cause of healthcare accounts receivable
High-performing practices don’t just fix denials; they work to prevent them from happening in the first place. That is where expert healthcare accounts receivable management services can really help you. Here are three main reasons why claims often end up in AR and how the right partner can help you stop that from happening.
1. Incomplete or inaccurate eligibility verification
The problem:
The front desk staff probably has a lot of tasks to take care of like: taking phone calls, checking patients in. It is possible for them to overlook procedures like appropriately confirming insurance or looking for secondary coverage because they have so much to take care of. However, even minor errors in this area may result in claims being rejected or payments being delayed.
The solution:
A specialized healthcare accounts receivable company gives you access to tools that instantly check eligibility. Beyond confirming active coverage, these systems capture a lot of important details like unmet deductibles, out-of-pocket maximums, referral or prior authorization requirements, and secondary insurance status. This will help you in spotting problems early and might improve the chances of getting claims paid on the first submission.
Pro tip:
Eligibility errors cause about 20–25% of claim denials. Just fixing this step at your front desk can boost your first-pass resolution rate by up to 12%.
2. Coding and documentation mismatches
The problem:
When managing multiple medical specialties or working with different EHR systems, coding errors can easily occur. A single incorrect modifier or an overlooked note might result in a claim denial. Even dedicated in-house coders, despite their efforts, are often overwhelmed or may not be fully versed in the latest payer-specific guidelines.
The solution:
When you outsource healthcare accounts receivable, you get access to certified coders who focus on your specialty. These experts know exactly what each payer expects and make sure your documentation and codes are a perfect match.
Real example:
One practice that outsourced its coding saw a 30% drop in coding-related denials in just 90 days. That is the kind of result you could see as well.
3. Delay in claim submission or payer response
The problem:
If there is a delay between when a practice sees a patient and when the claim is submitted or between submitting the claim and following up, the practice is giving payers the upper hand. The longer it takes, the harder it is to get paid quickly.
The solution:
When you work with a trusted healthcare accounts receivable services partner, your claims don’t sit around waiting to be sent. Instead of batching claims weekly, they make sure your claims go out every single day.
They also use clearinghouses and tracking tools to confirm that your claims are received and processed without delay. If something gets stuck or isn’t acknowledged by the payer, automated alerts kick in, so action is taken fast. Some partners even use AI to spot payer delays or flag claims that need urgent attention, helping you speed things up and improve your cash flow.
The impact:
By shortening the time between submitting a claim and getting paid, practices often see a 15–20% drop in AR days. That’s a big win for your revenue cycle.
What you gain: the cumulative impact
| Benefit | Measurable Result |
| Higher first-pass rate | Reduced rework & staff burnout |
| Faster cash flow | Improved financial planning |
| Lower denial rates | Less time spent on appeals |
| Fewer write-offs | More revenue collected |
Why practices are choosing to outsource healthcare accounts receivable services
It takes a skilled team, ongoing training, and technology that many small to mid-sized practices may not have. That is why more and more practices are choosing to outsource healthcare accounts receivable to companies that specialize in it.
If you are thinking about outsourcing, here is what you should look for in a good AR partner:
1. A proven track record
You should choose a partner who can show you real results, like better first-pass rates backed by data, not just stories.
2. Smart technology
Your partner should use tools like payer-specific rules, clearinghouse connections, and automation to catch and fix issues before claims are sent out.
3. A dedicated team for denials
It’s not just about submitting clean claims. You also need a team focused on fixing denials and following up quickly, so no claim falls through the cracks.
Prevention > Cure
Situations like chasing down unpaid claims every day can wear you out, but it doesn’t have to be that way. The most successful practices don’t just spend more time on collections; they stop claims from going into AR in the first place. That kind of change starts with improving your first-pass resolution rate. And that’s exactly where healthcare accounts receivable management services can help you make a real difference.