What We Do
Revenue Recovery

Revenue Recovery Solutions

Technology-powered solutions to recover more revenue

Speed collection of unpaid and underpaid reimbursement with technology-powered solutions for managing commercial plan claim denials, complex claims, accounts receivable and patient payments. Our revenue recovery solutions expedite challenged claims by appealing and overturning denials, maximizing patient coverage options, and speeding payment for full account resolution.

AR Recovery

Accelerate revenue, reduce AR days and maximize payer reimbursement with deep analysis of your accounts receivable inventory for all payers. Our experts work as a dedicated extension of your team to continuously improve the time to collect on your inpatient and outpatient accounts receivable. Our process includes specialized recovery programs encompassing system conversions, safety net programs, AR cleanup, Veterans Affairs and Workers’ Compensation inventory management.

Denials Recovery

Speed up appeals, overturn denials and ensure full reimbursement with our full-service denials management solution. R1 Denials Recovery is a full-service solution staffed by experienced clinicians, attorneys, certified coders and reimbursement analysts to recoup earned reimbursement from commercial, government and managed care payers who have wrongfully denied or underpaid claims.

Complex Claim Referrals

Maximize reimbursement for Motor Vehicle Accident (MVA)/Third-Party Liability (TPL), Workers’ Compensation (WC) and Veterans Affairs (VA) claims. Our staff attorneys, clinicians and revenue cycle experts manage your complex claims from admission through resolution to ensure appropriate reimbursement for services delivered.

Early Out

R1 Early Out delivers comprehensive account resolution services with empathy and efficiency to elevate patient satisfaction while optimizing financial outcomes. Our patient-first ethos means our team is dedicated to having compassionate conversations that empower patients with personalized, affordable payment options for the best possible experience.

Healthcare revenue recovery: FAQs

Revenue recovery in healthcare refers to the process of identifying and recouping unpaid or underpaid claims from insurance companies or patients. It ensures healthcare organizations receive appropriate compensation for services rendered. This involves claim audits, denial management, accounts receivable scrutiny and resolving billing errors to maximize revenue. Effective revenue recovery improves cash flow for a better bottom line, reduces financial losses and supports the sustainability of healthcare operations.

The purpose of revenue cycle management (RCM) in healthcare is to optimize the financial processes involved in patient care, from pre-service to appointment scheduling to final payment collection from insurance companies and patients. RCM ensures accurate billing, timely claims submission and effective management of denials. By streamlining these processes, healthcare providers improve cash flow, reduce errors and enhance the patient experience, ultimately supporting the organization’s financial health and operational efficiency.

Healthcare organizations can improve revenue recovery through focus on accurate coding, thorough claim audits, and efficient denials management. Training staff on compliance and billing best practices is crucial. Most in-house teams use third-party experts (like R1) that provide specialized services, including AR and Denial solutions, advanced technology and specialized expertise. By leveraging outside revenue recovery support in tandem with in-house teams, organizations reduce administrative burdens, improve cash flow and free up time to focus on patient care.

A Healthcare Revenue Recovery Group (HRRG) is a specialized organization that assists healthcare providers in recovering unpaid or overdue medical debts. They manage accounts receivable by engaging with patients and insurance companies to resolve outstanding balances and prevent bad debt. HRRG ensures compliance with regulations while offering patient-friendly solutions, such as payment options. Their services improve cash flow, reduce bad debt, and support the bottom line financial stability of healthcare organizations.