How We Recovered $180,000 in Aging Urology Claims Older Than 120 Days
Urology billing often involves high-value procedures, complex payer requirements, surgical documentation, and frequent prior authorization challenges. When aging claims are not actively managed, practices can accumulate significant outstanding accounts receivable that directly impact cash flow and profitability.
In this case, a Florida-based urology group with multiple providers had accumulated over $180,000 in claims aged beyond 120 days. Despite generating more than $900,000 in monthly charges, unresolved denials, payer delays, and insufficient follow-up processes had created a growing backlog of aging accounts receivable.
MBW RCM conducted a comprehensive A/R assessment and implemented a structured aging claims recovery strategy focused on high-value outstanding balances, payer escalation, and denial resolution.
Client Overview
Location: Florida, USA
Practice Type: Multi-Provider Urology Group
Providers: 6 Urologists and 3 Advanced Practice Providers
Services Covered: Office visits, cystoscopy, prostate procedures, lithotripsy, urodynamics, and surgical urology services
Average Monthly Charges: $900,000
Outstanding A/R Over 120 Days: $180,000+
Average Monthly Collections Before Intervention: $620,000
Primary Payers: Medicare, Commercial PPOs, Medicare Advantage Plans
The practice had experienced increasing aging accounts receivable due to unresolved denials, delayed payer responses, and inconsistent follow-up efforts, leaving substantial revenue uncollected.
Key Challenges in Urology Aging A/R Recovery
The aging balance of more than $180,000 was driven by several recurring billing and collections challenges that had not been systematically addressed.
High-Value Surgical Claims Stuck Beyond 120 Days
Many aging balances involved surgical procedures such as cystoscopy, prostate interventions, and stone management services. Claims remained unpaid due to documentation requests, medical necessity reviews, and unresolved payer inquiries.
Denials Left Unworked After Initial Rejection
Several claims had received denial responses but were never appealed or corrected. Common denial categories included CO-16, CO-50, CO-97, and authorization-related denials that remained unresolved for months.
Inconsistent Follow-Up on Outstanding Payer Balances
Insurance follow-up activities were sporadic, with some claims lacking payer contact for more than 60 days. This allowed many accounts to move deeper into aging categories without active collection efforts.
Missing Documentation and Medical Records Requests
Payers had requested operative reports, pathology reports, and clinical documentation for numerous high-dollar claims. These requests were not consistently tracked, resulting in avoidable payment delays.
No Prioritization of Recoverable Aging Claims
The practice lacked a structured methodology to identify which aging claims had the highest likelihood of recovery. Staff resources were spread across all accounts equally, limiting collection effectiveness.
Limited Visibility Into Aging A/R Trends
Without detailed aging analytics, leadership could not identify payer-specific bottlenecks, recurring denial patterns, or recovery opportunities within the outstanding balances.
Our Solution: Aging Claims Recovery Strategy
MBW RCM implemented a focused A/R recovery program designed to identify, prioritize, and resolve high-value claims exceeding 120 days.
| Challenge Identified | Solution Implemented |
|---|---|
| Surgical claims pending documentation review | Conducted claim-level audits and submitted missing operative reports, pathology records, and medical necessity documentation. |
| Unresolved denials older than 120 days | Established dedicated denial recovery workflows with payer-specific appeal strategies. |
| Lack of payer follow-up | Implemented systematic insurance follow-up schedules with escalation protocols for stalled claims. |
| Documentation requests not tracked | Created centralized documentation tracking and submission processes. |
| No prioritization of aging balances | Segmented claims by balance size, payer, denial reason, and recovery probability. |
| Limited aging visibility | Developed customized aging dashboards and recovery reporting by payer and claim category. |
This approach enabled the practice to focus resources on the claims most likely to generate immediate financial recovery while preventing additional balances from aging unnecessarily.
Aging A/R Recovery Results Within 120 Days
$180,000 recovered from claims aged over 120 days
68% of targeted aging balances successfully collected
A/R over 120 days reduced by 57%
Average A/R days decreased from 74 to 46 days
Denial appeal success rate improved from 41% to 79%
Insurance follow-up productivity increased by 65%
Monthly collections increased by approximately 15%
Documentation-related payment delays significantly reduced through proactive record submission
Conclusion
For this Florida-based urology practice, aging accounts receivable had become a substantial barrier to revenue performance. High-value surgical claims, unresolved denials, and inconsistent payer follow-up contributed to more than $180,000 in outstanding balances beyond 120 days.
By implementing a structured aging claims recovery strategy, MBW RCM successfully recovered $180,000 while strengthening the practice's overall revenue cycle processes. The result was improved cash flow, reduced aging A/R, and a more efficient collections operation.
Are Aging Claims Reducing Your Urology Practice Revenue?
Outstanding claims older than 120 days often represent recoverable revenue when supported by the right follow-up and denial management strategy. Download the full case study and connect with our specialists.
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