Should you outsource aged A/R?

The decision in one table

Why in-house teams struggle with aged claims

A billing team measured on days in A/R and clean-claim rate will rationally work this week's claims first. Aged claims each take longer (a call, a records request, an appeal letter) and displace several new claims. Physician practices already report substantial staff time on prior authorization alone, according to the AMA's annual physician survey. Adding appeal work for old denials on top of that rarely happens without a dedicated person.

What a contingency arrangement should include

• Fee only on remittances actually received, calculated monthly in arrears, at a rate fixed before work starts. Rates of 15–30% are common in the market for aged queues; MARR Partners charges 12–18% tiered by claim age.
• No setup fee, no minimum, no software license, and no charge for claims closed as unrecoverable.
• Scope limited to the aged insurance queue: nothing under 90 days unless you ask, and no patient balances.
• Money flows to the practice, never through the vendor. Remittances go to your lockbox and are reconciled to the claims worked.
• A BAA and minimum-necessary access: read-only system access or claim-level exports, not full administrative rights (HHS).
• Claim-level reporting: what was worked, what was recovered, why the rest was closed, and the denial root causes to fix upstream.
• A free audit first, so you know the recoverable amount before you commit.

What not to outsource

Charge entry, coding, claim submission, and posting belong with the team that knows your providers. Patient balances should stay with the practice or a patient-friendly statement vendor; a firm that recovers insurance claims should not be calling your patients. And do not outsource the root-cause fixes: the point of the denial data in the monthly report is that your team uses it.