Many physician practices assume revenue cycle challenges are primarily caused by low reimbursement, payer policies, or coding changes.

However, one of the most common sources of lost revenue is much simpler:

Claims that stop moving through the revenue cycle. 

In a recent engagement, Peregrine Healthcare recovered $440,540 in revenue for a pain management practice by identifying and resolving claims that had been sitting in unworked accounts receivable (A/R). The revenue did not come from new services or additional patient volume.
It came from existing claims that had stalled or had never been fully pursued.

The Problem: Aging Accounts Receivable That Had Stalled

Like many busy physician practices, the organization had a growing balance of aging accounts receivable that had not been systematically worked.

Several common revenue cycle challenges were identified:

• Claims submitted but never followed up on
• Denials that were never appealed
• Claims stalled within payer processing systems
• Older accounts assumed to be uncollectible

Over time, these claims accumulated in aging A/R and were at risk of being written off as lost revenue.

This scenario is not unusual. Industry benchmarks from organizations such as the Healthcare Financial Management Association (HFMA) and the Medical Group Management Association (MGMA) indicate that inefficient denial management and claims follow-up can result in 3–6% of collectible revenue being lost if claims are not actively managed.

The Solution: Structured A/R Recovery and Denial Management

Peregrine Healthcare conducted a comprehensive review of the practice’s aging accounts receivable and implemented a targeted recovery strategy.

The approach focused on three primary areas.

1. Comprehensive A/R Review

The first step was identifying recoverable claims that had stalled or had never been fully worked.

Each account was evaluated based on payer timelines, claim status, and supporting documentation to determine whether recovery was still possible.

Many claims remained within payer filing or appeal windows and were eligible for recovery with proper follow-up.

2. Systematic Denial Follow-Up

Denied claims often represent recoverable revenue when they are properly reviewed and appealed.

The Peregrine Healthcare team conducted a structured denial review that included:

• Reviewing documentation to confirm medical necessity
• Submitting formal appeals where appropriate
• Communicating with payers to resolve stalled claims

In many cases, the practice’s documentation supported the billed services, allowing claims to be reprocessed and paid.

3. Targeted Payer Follow-Up

Older claims that had stalled within payer systems were escalated through targeted payer communication.

This follow-up process helped determine claim status and move accounts toward resolution.

As a result, many claims that had previously stopped moving through the revenue cycle were successfully reprocessed and paid.

Revenue Recovered

Through systematic A/R review, denial appeals, and payer follow-up, Peregrine Healthcare recovered $440,540 in revenue for the practice.

This revenue came from claims that had stalled or had not been fully pursued and would likely have been written off without focused recovery efforts.

Why Unworked A/R Happens in Physician Practices

Unworked accounts receivable often accumulate due to operational pressure rather than billing errors.

Common contributing factors include:

• Limited staff time to pursue older claims
• High denial volumes requiring detailed appeals
• Lack of structured A/R follow-up workflows
• Revenue cycle teams focused primarily on current claims

When claims stop receiving attention, they move into older aging buckets and eventually become write-offs instead of collections.

What This Means for Medical Practices

Many practices assume their revenue cycle is already optimized.

However, even well-run organizations may have significant revenue sitting in aging claims that simply require structured follow-up.

A focused review of aging accounts receivable can often uncover:

• Recoverable denials
• Stalled claims awaiting payer action
• Underpayments
• Claims that were never fully pursued

In many cases, these opportunities exist without increasing patient volume or adding new services.

How Much Revenue Can Be Recovered from Unworked A/R?

Unworked accounts receivable can represent a substantial source of recoverable revenue for physician practices.

In this case study, Peregrine Healthcare recovered $440,540 from aging accounts receivable after implementing structured denial management and claim recovery processes.

Recoverable A/R often includes:

• Claims that were submitted but never followed up on
• Denials that were never appealed
• Claims stalled in payer processing
• Older accounts incorrectly assumed to be uncollectible

Industry benchmarks from MGMA and HFMA suggest that inefficient denial management and claims follow-up may result in 3–6% of collectible revenue being lost if claims are not actively managed.

Final Takeaway

Revenue cycle performance is not only about billing new services. It is also about protecting revenue that has already been earned.

The recovery of $440,540 in unworked accounts receivable in this case study demonstrates how significant these opportunities can be.

For many physician practices, aging A/R may represent recoverable revenue that has simply gone unnoticed.

Frequently Asked Questions

What is unworked accounts receivable in healthcare?

Unworked accounts receivable refers to medical claims that have been billed but are not actively followed up on. These claims may include denied claims, stalled claims, or accounts that have aged without payer communication or appeal activity.

Why do medical practices accumulate aging A/R?

Aging A/R often accumulates because revenue cycle teams focus on current claims while older claims receive less attention. Staffing limitations, high denial volumes, and lack of structured follow-up processes can contribute to unworked accounts receivable.

Can denied medical claims still be paid?

Yes. Many denied claims can be successfully appealed if documentation supports the billed services and appeals are submitted within payer deadlines.

How much revenue can practices lose from poor denial management?

Industry benchmarks from organizations such as HFMA and MGMA suggest that 3–6% of collectible revenue may be lost due to inefficient denial management and claims follow-up.

How can practices recover revenue from aging accounts receivable?

Recovering revenue from aging A/R typically involves reviewing older claims, appealing denied claims with proper documentation, communicating with payers to resolve stalled claims, and implementing structured follow-up workflows.

Identify Revenue Hidden in Your A/R

Many practices have revenue sitting in aging accounts receivable simply because claims were never fully pursued.

A structured revenue cycle review can help identify recoverable claims, unresolved denials, and stalled payments.

Request a complimentary revenue cycle review to see what opportunities may exist within your practice’s A/R.

 877-463-1110

Practice name withheld for confidentiality. Financial results are based on actual recovery data from the engagement.