Accounts Receivable (A/R) Follow-Up Automation
Work every aged claim continuously — not just the ones a person has time for today.
Short answer: A/R follow-up automation uses AI to continuously work aged claims — checking claim status via the 276/277 EDI transaction, sorting claims into A/R aging buckets, routing each by its CARC/RARC denial reason code, and flagging timely-filing deadlines. RCM Employee's A/R Aging & Follow-Up Digital FTE does this API-first (no browser automation), processing Excel/CSV worklists exported from your EHR to reduce days in A/R for U.S. practices, hospitals, and nurse practitioners.
What the A/R Digital FTE actually does
Manual A/R follow-up never finishes — there are always more aged claims than hours in the day. The A/R Aging & Follow-Up Digital FTE works the entire backlog instead of a sample of it:
- Checks claim status using the 276/277 EDI transaction through Stedi or Availity — no portal logins, no screen scraping.
- Works A/R aging buckets — 0–30, 31–60, 61–90, and 90+ days — prioritizing the claims most at risk.
- Routes by reason code — interprets CARC/RARC codes on each response and decides the right next step.
- Flags timely-filing deadlines so claims aren't lost to the filing window.
- Processes Excel/CSV worklists exported from the EHR, returning a worked, annotated worklist.
API-first, never screen scraping
Every status check runs through real EDI transactions (276/277) over Stedi or Availity. There is no browser automation, no robotic clicking through payer portals, and no screenshots of PHI. API-first access is auditable, encrypted in transit, and deterministic — the right architecture for HIPAA-compliant A/R work.
How it reduces A/R days
Days in A/R climb when claims sit unworked. Because the Digital FTE works continuously — up to 24/7 on the Professional plan — no aging bucket goes untouched:
- Every claim in the worklist gets a status check, not just the top of the pile.
- Denials surface immediately by CARC/RARC code instead of weeks later.
- Timely-filing risks are flagged before the window closes.
- Staff spend their time on resolution and judgment calls, not repetitive status lookups.
Results vary by payer mix, specialty, and worklist volume — but working the full backlog without gaps is what shortens A/R.
HIPAA & security
- Encrypted at rest with AWS KMS and in transit with TLS.
- Per-practice isolation — your claims and PHI are scoped to your organization.
- BAA chain covering every party that touches PHI.
- 7-year audit log of activity for compliance and review.
Pricing
Simple, credit-based plans — no per-claim fees and no token math:
- Pay-as-you-go — credit-based, $250/mo minimum.
- Standard — $3,500/mo, business-hours coverage.
- Professional — $5,500/mo, 24/7 coverage for continuous A/R follow-up.
Frequently asked questions
- What is A/R follow-up automation?
- AI that continuously works aged claims — 276/277 claim status, A/R aging buckets, CARC/RARC routing, and timely-filing alerts — from your EHR worklists.
- How does it check claim status?
- Through the 276/277 EDI transaction over Stedi or Availity — API-first, with no browser automation or portal scraping.
- Does it work my EHR worklists?
- Yes — it processes Excel/CSV worklists exported from the EHR and returns them worked and annotated by aging bucket and reason code.
- Is it HIPAA compliant?
- Yes — KMS encryption at rest, TLS in transit, per-practice isolation, a BAA chain, and a 7-year audit log.