RecoveAR · Denial & AR Recovery

The claim that pays is the one filed before its window shuts.

RecoveAR ranks every open denial by how close it sits to a filing or appeal deadline, not by how large the balance is. The accounts about to expire get worked first, so revenue never dies on the calendar instead of on the merits.

FRESH AGING EXPIRING
The short answer

Balance size tells you what an account is worth. Deadline proximity tells you whether you can still collect it.

A $12,000 denial with 200 days left on the appeal clock is safer than an $800 denial with 6 days left. Worked by balance, the small one dies first. RecoveAR reads the payer's own filing and appeal rules, calculates each account's true days-to-deadline, and pushes the ones nearest the edge to the top of the queue every morning.

The deadline wall

Where aging AR crosses the lines it can never cross back

These are not estimates. They are the filing and appeal windows written into the guidelines RecoveAR sequences against. When an account passes one, the money is gone regardless of how clean the claim was.

365
days to file
Medicare fee-for-service timely filing, from the date of service.
CMS Pub. 100-04, Ch. 1, §70 · SSA §1842(b)(3)(B)
120
days to appeal
Medicare redetermination, the first-level appeal, from receipt of the initial determination.
CMS Pub. 100-04, Ch. 29 · 42 CFR §405.942
180
days to appeal
Medicare reconsideration by the QIC, the second-level appeal.
42 CFR §405.962 · CMS Pub. 100-04, Ch. 29
90–180
days to file
Typical commercial payer timely-filing window, set by contract and often the tightest clock in the book.
Per individual payer provider manual / participation agreement
95–365
days to file
Medicaid timely filing, varying widely by state and by original-vs-resubmission rules.
Applicable state Medicaid provider billing manual
30
business days
No Surprises Act open negotiation period for out-of-network payment disputes, before IDR can begin.
No Surprises Act · 45 CFR §149.510
4
business days
Window to initiate Federal IDR after the open negotiation period ends. Miss it and the dispute is closed.
No Surprises Act IDR process · 45 CFR §149.510(c)
1
queue, sorted
RecoveAR collapses all of these clocks into one work list, ordered by days remaining.
Deadline-proximity engine, refreshed daily
One account, three clocks

The life of a denied claim, from clean to closed

A single Medicare denial can pass three separate deadlines on its way to write-off. RecoveAR tracks each one and flags the account the moment it enters a danger band.

Day 0
Date of service. The filing clock starts.
+120 days
Redetermination window if denied. Appeal or lose level one.
+180 days
QIC reconsideration window opens and closes on its own clock.
Day 365
Medicare timely filing ends. No refile, no appeal, no exception.
How RecoveAR sequences the work

Deadline in, priority out

The engine runs the same five steps on every open account, every day, so the list a caller opens in the morning is already ordered by what is about to expire.

STEP 01

Read the rule

Match each claim to its payer, plan, and claim type, then pull the exact filing and appeal windows that apply.

STEP 02

Anchor the date

Set the clock from the correct trigger: date of service, remit receipt, or negotiation close, not the day someone noticed.

STEP 03

Score proximity

Compute days remaining on the nearest live deadline and weight it against recoverable dollars.

STEP 04

Band the risk

Sort into green, amber, and red bands so expiring accounts surface above fat but comfortable ones.

STEP 05

Route to work

Push red-band accounts to the top of the caller queue with the appeal path and deadline already attached.

Why the order matters

Balance-size triage vs. deadline-proximity triage

What you are optimizing
Sort by balance size
Sort by deadline (RecoveAR)
First account worked
Largest dollar amount, whatever its age
Nearest to a filing or appeal deadline
Small, expiring claims
Sink to the bottom, age out silently
Surfaced while there is still a window to appeal
Large, comfortable claims
Worked first even with 200 days left
Held until their clock actually tightens
Timely-filing write-offs
Discovered after the deadline has passed
Prevented, because proximity drives the queue
What the calendar decides
Which recoverable claims quietly die
Nothing. The merits decide, not the date
The rules RecoveAR runs on

Real deadlines, cited by name

The engine is only as good as the guideline library behind it. RecoveAR sequences against the same published rules your auditors would check.

Federal · Medicare

CMS Claims Processing Manual

Pub. 100-04, Chapter 1 sets the one-calendar-year timely-filing limit; Chapter 29 governs the five-level appeals process and each level's clock.

365 days to file · 120 to redetermine
Payer · Commercial & Medicaid

Payer timely-filing & appeal deadlines

Each commercial provider manual and state Medicaid billing manual sets its own filing and appeal windows. RecoveAR keys them per payer, plan, and claim type.

90–365 days, contract-specific
Federal · Out-of-Network

No Surprises Act IDR timelines

A 30-business-day open negotiation period, then a 4-business-day window to initiate Federal IDR under 45 CFR §149.510. The tightest reflex clock in the stack.

30-day negotiate · 4-day IDR trigger

Find out how much of your AR is already against the clock.

ASP-RCM Solutions runs RecoveAR on your open denials to show exactly where accounts sit relative to their filing and appeal windows, and what is recoverable before those windows close. No fabricated projections, just your real AR mapped to real deadlines.

Talk to ASP-RCM about RecoveAR →

Deadlines cited reflect CMS and federal rules current for 2026. Payer and state Medicaid windows vary by contract and jurisdiction; RecoveAR keys each account to its governing manual.