Компания Capline внедрила новую модель взыскания дебиторской задолженности, позволяющую медицинским практикам увеличить доходы на 35%

Houston-based RCM company rolls out a disciplined, age-based accounts receivable follow-up model to help medical practices recover aging claims and reduce balances stuck past 90 days. HOUSTON, Aug. 27, 2026 /PRNewswire/ -- Capline Healthcare Management, a U.S.-based revenue cycle management company, has introduced a structured accounts receivable (AR) follow-up strategy designed to help healthcare practices recover up to 35% more revenue while reducing the volume of claims sitting past 90 days. The figure is based on an internal analysis of 30 medical practices using Capline's Billing and Collection services between July 01, 2025, and July 01, 2026. Over that period, Capline recovered an average of 28% of eligible outstanding insurance A/R older than 90 days within 30 days of assignment, with recovery reaching 35% in the highest-performing offices. That collected revenue contributed to a 7 to 10 percentage-point improvement in the practices insurance collection rates, helping the analyzed cohort reach a net collection rate above 95% within the first quarter of engagement. For many practices, the problem isn't that claims go unpaid forever. It's that they sit. A claim gets submitted, a payer asks for more information, and no one circles back in time. Weeks turn into months, and by the time someone notices, the claim has already missed a corrected-claim, reconsideration or appeal deadline. Capline's approach is built to close that gap by tracking every outstanding claim by age, cause, and payer, and following up before it becomes a write-off. "Most practices don't lose revenue because claims are denied outright. They lose it because no one goes back to check on what's still pending," said Abhinav Rastogi, Founder, Capline Healthcare Management. "A structured AR follow-up process means every outstanding dollar has someone responsible for chasing it down, on a schedule, before it ages out." Why Aging AR Is a Growing Problem Unpaid claims are one of the most persistent drains on practice revenue, and the problem tends to get worse the longer a claim sits untouched. According to the Healthcare Financial Management Association (HFMA), practices should aim to keep days in accounts receivable between 30 and 40, with total AR older than 90 days held under 10% of the total outstanding balance. The Medical Group Management Association (MGMA) reports a similar benchmark range of 12% to 15% for AR over 90 days, and its own 2021 DataDive Cost and Revenue survey found the median share of AR older than 120 days in multispecialty practices had climbed to 13.54%. MGMA's 2024 Cost and Revenue Survey shows a similar gap in another key metric, days in A/R. Top-performing practices average 36 days, close to HFMA's 35-day target midpoint, while the broader sample climbs to a median of 47 days, well outside the 30-to-40-day range. Across both measures, the pattern is the same: practices are sitting further from the benchmark than industry guidance recommends. Capline's AR follow-up model is built around closing that gap. A Structured, Risk-Based A/R Follow-Up Process Rather than treating every unpaid claim the same way, Capline's A/R follow-up service combines aging analysis with financial value, payer status, filing deadlines and probability of recovery, so every outstanding account has a clear owner and a scheduled follow-up cycle through final resolution. Capline's process includes: - Risk-based prioritization: Claims are prioritized using a combination of age, outstanding value, timely-filing or appeal exposure, payer response status and likelihood of recovery rather than age alone. - Aging-bucket follow-up cycles: Accounts are organized into 0–30, 31–60, 61–90, 91–120 and 120+ day buckets, with follow-up frequency and escalation increasing as claims age or approach critical deadlines. - Root-cause classification: Every unpaid, underpaid or delayed claim is categorized by its underlying cause, such as eligibility, authorization, coding, documentation, payer processing, underpayment, timely filing or patient responsibility. - Corrective action and escalation: Depending on the identified issue, the team obtains claim status, submits missing information, corrects and resubmits claims, files appeals or escalates unresolved accounts through the appropriate payer channel. - Dedicated account ownership: Each claim is assigned to a responsible team member who documents every action and continues follow-up until the balance is paid, adjusted, or confirmed as uncollectible. - Performance reporting: Practices receive regular reporting on recoveries, pending balances, aging movement, payer issues, and unresolved accounts. By combining risk-based prioritization, dedicated ownership and measurable reporting, Capline's team can identify and resolve payment barriers before claims become harder to collect, while surfacing recurring causes of unpaid claims that reduce future 90 and 120-day A/R. Where the 35% Opportunity Comes From Capline believes the recovery opportunity is concentrated in the claims that practices tend to deprioritize: accounts that are old, low-dollar, or assumed to be a lost cause. In many cases, that revenue isn't gone, it's simply been sitting without anyone assigned to work it. Once a claim passes 90 days, it doesn't mean the money is unrecoverable. It typically means the claim needs someone to sit down, find out exactly where it stalled, and push it forward, a step most practices don't have the staff time for and one where Capline's AR team focuses its work. How much a practice recovers depends on its payer mix, specialty, and how far claims have already aged before bringing in outside support. Practices with a meaningful backlog of unworked AR are typically where Capline sees the largest gains. Built Into a Full-Cycle RCM Model Capline's AR follow-up work sits alongside its broader revenue cycle offering, which includes medical billing, coding, payment posting, and patient eligibility verification services on the front end. The company said connecting AR follow-up to the rest of the billing cycle, rather than treating it as an isolated task, helps prevent the same issues from resurfacing on future claims. Capline currently supports more than 1,300 independent medical practices across the United States. Mr. Rastogi further added, "Our job is to make sure outstanding revenue doesn't just sit there. Every claim in AR represents work a practice already did. We're focused on making sure they actually get paid for it." About Capline Healthcare Management Capline Healthcare Management is a Houston-based healthcare management company founded in 2016. The company has an A+ rating with the Better Business Bureau (BBB) and follows HIPAA-compliant practices to help ensure the confidentiality and privacy of sensitive healthcare data. Capline provides end-to-end revenue cycle management and back-office support services to healthcare practices across the United States. Its services include AR follow-up, medical billing, coding, payment posting, and eligibility verification. To learn more about Capline's revenue cycle services, visit https://www.caplinehealthcaremanagement.com. SOURCE Capline Services