Recover the money you have already earned but never received. We specialize in appealing wrongful denials, correcting underpayments, and clearing aged A/R.
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Most medical practices lose 5% to 15% of their revenue to billing errors, claim denials, and underpayments. We identify these leaks and systematically recover your cash.
Payer rules are designed to be complex, and automated system rejections make it easy for claims to get buried. Standard billing workflows are often too busy processing new submissions to spend hours contesting a $150 downcode or researching why a Medicare modifier failed. Over the course of a year, these minor losses aggregate into hundreds of thousands of dollars in lost net income.
Medical revenue recovery is not about billing new codes; it is about audits, tracking payer contract rates, and fighting wrongful denials. MD Revenue Group acts as a forensic audit team for your billing history, recovering cash from aged accounts receivable and underpaid encounters with clinical precision.
Insurers profit when claims go unpaid or underpaid. Here is where your practice is likely losing money:
An estimated 65% of denied claim dollars are never recovered because busy practices lack the time, resources, or specialized technical expertise to research, appeal, and resubmit them. This leaves billions of dollars on the table annually. Our recovery specialists challenge every wrongful denial with clinical evidence, technical coding proof, and payer-specific guidelines to overturn rejections.
Insurers frequently apply outdated fee schedules, ignore contractual rate increases, or downcode visits without clinical justification. Most billing software platforms only check if a claim is paid, not if it was paid at 100% of your contracted fee schedule. We audit every payment against your payer contracts to identify and recover underpayments.
Claims sitting in accounts receivable past 90 days have a high chance of becoming permanent write-offs due to timely-filing limits. Our recovery team targets aged claims, chasing insurance representatives and filing high-level appeals to extract cash from old balances before the filing window closes for good.
Many practices undercode complex visits or avoid using legitimate add-on codes out of fear of audits. This "defensive billing" strategy costs practices thousands of dollars in lost income. Our certified coders audit documentation to find missed charge captures, ensuring you are fully compensated for the complexity of care provided.
We run a systematic, database-driven recovery workflow to audit, appeal, and resolve aged claims.
We analyze your historical billing data going back 12 to 24 months. By comparing billed charges, contract fee schedules, and actual payments, we pinpoint exactly where revenue is leaking and trace the root cause of every denial pattern.
Once the leaks are identified, we build structured, evidence-based appeal packages. Our certified coders handle the administrative heavy lifting, submitting clinical notes, corrective coding, and contract documentation to payers.
We track every appeal through the payer queue. Our team stays on the phone with insurance representatives to ensure claims are reprocessed, paid at the correct rates, and reconciled in your practice management system.
Chasing old money is only half the battle. We work with your front desk and clinical staff to implement workflow adjustments, system alerts, and coding protocols that stop new revenue leaks before they start.
Different clinical specialties run on different coding structures, payer rules, and documentation standards.
Psychiatry and mental health practices face severe audit scrutiny on high-value therapy sessions (like 90837) and telehealth modifiers. Payers use automated algorithms to flag rounding patterns or missing treatment plan linkages. We audit and recover denied behavioral health claims by aligning documentation with time-based rules.
High-acuity emergency encounters (99285) are frequently downcoded by payers looking to reduce emergency department outlays. We synchronize facility-level and professional-level billing acuity, appeal level-5 downcodes, and manage the complex federal and state dispute resolution portals for out-of-network emergency reimbursements.
Internists lose significant revenue on Same-Day Wellness and E/M crossovers, Chronic Care Management (CCM), and longitudinal complexity add-on codes like G2211. We recover unpaid primary care claims and ensure proper modifier application to secure full compensation for comprehensive disease management.
Our recovery team includes AAPC-certified coders, contract compliance specialists, and dedicated appeal writers who analyze historical contracts and payer rules to extract maximum value from aged claims. Our clients see an average recovery of $118,000 in the first 6 months, and you pay nothing unless we recover money for you.
Standard medical billing focuses on submitting current claims and posting payments. Medical revenue recovery is a retrospective, forensic process. We look backward at your billing history to identify claims that were underpaid, incorrectly denied, or written off prematurely, and we systematically appeal them to collect the money your practice is legally owed.
We operate on a risk-free, performance-based pricing model. We only charge a percentage of the cash we actually recover for you. If we do not recover money from your aged accounts receivable or underpayments, you pay nothing. There are no upfront setup fees, monthly software charges, or hidden administrative costs.
Depending on timely-filing limits and individual insurance contracts, we can typically audit and appeal claims going back 12 to 24 months. Our initial forensic audit will analyze this historical window to determine which claims are still eligible for recovery under payer rules.
No. In fact, our process improves your compliance. Our certified coders ensure that all appeals align strictly with CMS guidelines, AMA CPT descriptors, and national billing standards. We correct coding errors in both directions—preventing both underpayments (undercoding) and compliance flags (overcoding) to protect your practice from future payer audits.
Minimal staff time is required. We handle the heavy lifting. Once you grant our team read-only access to your practice management and EHR systems, we perform the audit independently. We compile a clear, plain-language report showing our findings, and we only proceed with appeals once you give us the green light.
Our complimentary revenue recovery audit analyzes your historical billing to map and resolve leaks with zero risk.
