Unpaid Claims Are Killing Your Cash Flow — But Not for the Reason You Think!

Think of your practice revenue like a leaky faucet. You keep tightening the valve (coding audits, documentation fixes), but the drip doesn’t stop. Why? Because the leak isn’t in the faucet — it’s under the sink. Hidden. Silent. And just like that, unpaid claims are draining your cash flow — but not due to coding errors. The real issue? Inconsistent follow-up.

If you're a small or specialty practice in Arizona, chances are you’ve heard that unpaid claims stem from CPT® or ICD-10 coding mistakes. But here’s the truth: coding is only part of the story. The larger — and often ignored — problem is the lack of a structured, regular follow-up on unpaid medical claims Arizona providers desperately need.

What’s Really Killing Your Cash Flow?

It’s not your front-end coding. It’s your back-end process — specifically your Accounts Receivable (AR) aging past 60/90 days with no one chasing those dollars.

Let’s break it down:

●  You submitted a claim with correct CPT® codes.

●  It was denied with a payer denial code like CO-29 (timely filing expired) or CO-45 (charges exceed fee schedule).

●  And then… nothing.

●  No resubmission. No appeal. No call. No cash.

That’s not a billing error — that’s a process error.

Do You Know What Your AR > 90 Days Looks Like?

Here’s a red flag: If 20-30% of your AR is over 90 days, you’ve got a serious follow-up problem. According to the 2023 MGMA DataDive report, practices with robust follow-up systems collect 98% of their claims within 60 days, compared to only 74% for practices with weak AR management.

That gap? It's not just numbers — it’s your payroll, rent, and sanity at risk.

What If Your Denials Aren’t the Real Problem?

You could be resubmitting claims without fixing the root cause — and still getting denied. So, what’s happening?

●  Are your billers reading the denial codes right?

●  Is anyone talking to payers like Medicare or Medicaid to understand policy nuances?

●  Or worse — is no one following up at all?

This is where most small practices fall behind. You can’t afford to have your front desk person doubling up as your billing specialist.

Why Regular Follow-Up Is Your Practice's Lifeline?

For practices in Arizona — especially those in chiropractic, physical therapy, mental health, and nutritional therapy — staffing is often lean, and billing isn’t always your team's top skill.

Here’s where regular follow-up on unpaid medical claims Arizona practices ignore becomes vital:

●   It reduces AR aging

●   Speeds up reimbursements

●   Helps catch underpayments (especially CO-45 cases)

●   Ensures payers follow their timelines

Yet, it’s the first thing that falls through the cracks when your staff is overwhelmed.

Could You Be Leaving 30% of Your Income on the Table?

Yes, and you probably are.

Denials like CO-29 are avoidable with proactive follow-up before deadlines. CO-45? You can often recover underpayments — if someone is watching. Most practices lose money simply because no one’s asking for it.

So, if it’s not about codes... what’s the fix?

The Fix Isn’t Just Better Software — It’s Better People

Even the best EHR won’t call Aetna to fight a denied claim.

What you need is a team that lives and breathes RCM — people who understand payer behavior, know appeal language, and track every dollar that’s stuck in AR > 60/90 days. That's where outsourcing makes sense — especially when your clinical team is already stretched thin.

Billing Business Specialists LLC is already helping practices like yours across Arizona, managing everything from claim submission to aggressive AR follow-up, appeals, patient collections, and compliance with Medicare/Medicaid changes — so you can go back to being a provider, not a biller.

Final Thought: Is It Time to Stop Leaving Money on the Table?

Your unpaid claims don’t just affect your numbers — they impact your staff morale, patient experience, and growth potential. And if you think coding is the problem, think again. It’s what happens after the claim is submitted that defines your revenue success.

So, what’s your AR > 90 days telling you?

FAQs

1. Why are my medical claims going unpaid even if codes are correct? 

Most likely, the issue is lack of follow-up. Denied claims require consistent tracking, payer communication, and timely resubmissions.

2. How can I reduce my AR > 60/90 days? 

Start with a structured, weekly claim follow-up workflow. Prioritize high-value claims and denial codes like CO-29 and CO-45.

3. What is the most common reason for delayed payments from payers? 

Apart from coding errors, the biggest reason is failure to respond to denials or requests for additional documentation on time.

4. Should small practices outsource billing? 

Yes, especially if you’re understaffed or lack trained billers. Outsourcing ensures faster claim turnaround and consistent cash flow.

5. How often should I do a regular follow-up on unpaid medical claims? 

At least weekly. For practices in Arizona, setting up regular follow-up on unpaid medical claims Arizona providers neglect can drastically improve revenue.

Ready to Stop Chasing Dollars and Start Collecting Them?

Let’s talk about how Billing Business Specialists LLC can become your go-to team for regular follow-up on unpaid claims Arizona small clinics need to survive and scale.

We make sure no claim gets left behind — so you don’t leave money on the table!