How to Reduce Aged AR and Claim Denials in Internal Medicine Billing?

Internal medicine billing services directly impact how quickly a practice gets paid. When claim rejections and aging AR build up, practices face lower collections, delayed reimbursements, and tighter cash flow.

The good news? Denials and delays are often preventable with the right strategies. In this blog, you’ll discover actionable tactics to streamline internal medicine billing, including payer-specific fixes, real-time denial prevention tools, and optimized workflows.

Whether you’re a billing specialist or practice manager, these data-driven solutions will help you accelerate reimbursements, reduce AR days, and protect your practice’s bottom line.

For a comprehensive roadmap to internist-specific billing, refer to our Internist Medical Billing Guide.

📢 Losing Revenue to Claim Denials or Aging AR?

At Medibill RCM LLC, our internal medicine medical billing services are designed to fix the root causes of revenue loss denials, slow reimbursements, and AR over 90 days.

We help internal medicine practices:

✔ Cut denial rates with real-time eligibility and coding accuracy
✔ Reduce AR aging through automated follow-up workflows
✔ Prevent claim rejections with proper modifier use and documentation checks
✔ Improve collections using payer-specific strategies and clean claim scrubbing

📍 Trusted by internal medicine providers across Texas and nationwide

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Discover where revenue is leaking and how to fix it before write-offs grow.

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What Causes Aged AR and Claim Denials in Internal Medicine Billing?

Internal medicine billing faces unique complexities due to chronic care management coding, frequent E/M documentation updates, and inconsistent payer adjudication.

Stay compliant with the latest E/M coding updates for internists, including revised MDM scoring.

These challenges drive two major revenue cycle disruptions:

Aged AR (Accounts Receivable)

Claims left unpaid for 30, 60, or 90+ days, hurting cash flow. Common culprits include:

• Payer delays (e.g., backlogged claims, slow reprocessing)
• Inefficient follow-up (e.g., missed appeals, untimely resubmissions)
• Credentialing gaps (e.g., outdated provider enrollment)

Claim Denials

Rejections are often tied to:

• Coding errors (e.g., mismatched E/M levels, unbundled services, modifier misuse)
• Eligibility breakdowns (e.g., coverage termination, missed prior authorizations)
• Documentation deficiencies (e.g., unsigned notes, inadequate medical necessity proof)

How incomplete SOAP notes become top audit triggers for internal medicine claims.

• Technical failures (e.g., missed timely filing deadlines, incorrect patient demographics)

Avoid the 10 most common medical billing denials that plague internal medicine practices.

Proactive measures, targeted denial management, and aggressive AR follow-up are critical to recapturing lost revenue and optimizing cash flow.

How Can Internal Medicine Practices Prevent Claim Denials Before Submission?

1. Verify Patient Eligibility in Real-Time

Problem: Denials due to inactive coverage, invalid referrals, or missing authorizations.

Solution:

• Use EDI 270/271 transactions for instant insurance verification (e.g., Waystar, Availity).

Step-by-step guide to automating eligibility checks in internal medicine RCM

• Confirm prior authorization requirements for high-cost services (e.g., diagnostics and infusions).
• Update insurance details at every visit (front desk checks + patient portal reminders).

✅ Real-World Impact: A 30-second eligibility check could prevent a $200+ claim denial from an expired policy.

2. Ensure Accurate Coding & Modifiers

Problem: Denials from incorrect CPT/ICD-10 codes or modifier misuse.

Solution:

• Train providers on E/M level selection (e.g., 99213 vs. 99214 based on MDM complexity).

See a side-by-side comparison of E/M coding differences between internal medicine and family practice.

Use our medical coding workflow checklist to avoid upcoding/downcoding errors.

• Key modifiers: -25 (separate E/M + procedure same day), -59 (distinct procedures, bypassing NCCI edits).
• Link diagnoses properly (e.g., hypertension with CKD in chronic care visits).

✅ Example: Billing 36415 + 99213 without modifier -25? That’s a bundling denial waiting to happen.

3. Scrub Claims Before Submission

Problem: Rejections from missing data, invalid codes, or duplicates.

• Missing DOB/Policy numbers
• Incorrect CPT-ICD-10 pairs (e.g., R05.9 with 99214?)
• Duplicate charges
• Payer-specific rules (e.g., Medicare’s ABN requirements)

✅ Data Point: Practices using automated scrubbers reduce rejections by 30% + before submission.

Implement AI-powered claim scrubbing techniques to catch errors like mismatched ICD-10/CPT codes before submission.

Important Note: While these strategies are proven to reduce denials, always verify payer-specific guidelines and consult your billing compliance team for practice-specific implementation. Results may vary based on your EHR, payer mix, and workflow adoption.

What Are the Best Ways to Reduce Aged AR in Internal Medicine Billing?

1. Work Denials Promptly

• Delay reduces recoverability.
• Assign a dedicated denial management team.
• Sort denials by reason codes, e.g., “missing documentation,” “non-covered service.”
• Create templates for common appeal letters to speed up recovery.

While aiming for quick resolution, prioritize denials based on potential recovery value and complexity, addressing simpler denials first while allocating more time for complex cases.

2. Prioritize Aged and High-Dollar Claims

Avoid write-offs by targeting critical AR segments:

• Categorize AR into aging buckets: 0-30, 31-60, 61-90, 90+ days.
• Focus first on: Claims nearing payer deadlines. High-ticket services (e.g., chronic care management, injections, vaccinations)

Use payer-specific timely filing deadlines table to prioritize high-risk claims.

• Analyze aging reports and prioritize claims based on a combination of age, dollar value, and collectability to ensure a comprehensive approach.

Metric: Aim to keep AR >90 days below 10% of total AR.

3. Automate Follow-Up with AR Management Software

• Manual follow-ups waste time.
• Leverage AR management software to track payer responses and automate reminders for: 1) Unpaid claims, 2) Payer response deadlines, and 3) Follow-up action steps.
• When escalating AR older than 90 days to collections, prioritize ethical and patient-centered approaches such as clear communication, offering payment plans, and demonstrating empathy.

Best Practice: Generate weekly AR aging reports and assign tasks based on claim status. Select software solutions that align with your practice’s specific workflow and needs to enhance efficiency.

How to Adapt to Payer-Specific Rules and Improve Reimbursement?

1. Maintain a Payer Rulebook

Each payer follows distinct denial triggers and policies.

• Develop a payer cheat sheet (e.g., UHC modifier policies, Medicare LCDs).
• Subscribe to payer updates to track evolving rules and requirements.
• Log denial reasons in your billing system to identify trends and refine processes.

Understanding payer-specific rules reduces resubmissions and appeals. Consistent monitoring ensures long-term compliance and efficiency.

Compliance Note: Staying current with payer policies is critical to avoid regulatory penalties and ensure adherence to healthcare billing standards.

2. Negotiate Stronger Payer Contracts

Low reimbursements contribute to AR challenges.

• Audit top-billed codes against payer fee schedules.
• Pinpoint high-volume, low-margin services.
• Leverage data to renegotiate rates for:
  • Chronic care management (99490, 99491)
  • Preventive services
  • Telehealth visits

Practices that regularly renegotiate contracts often secure better terms, though outcomes depend on negotiation leverage and payer dynamics.

 Key Considerations:

• Negotiation Leverage: Success hinges on demonstrating the practice’s value (e.g., patient volume, quality metrics) to payers.
• Professional Support: MediBill RCM LLC supports internal medicine practices by helping them streamline compliance and strengthen payer negotiations, whether through in-house teams, revenue cycle management experts, or trusted billing consultants.

How Can Technology and Training Help Reduce Denials?

1. Leverage Denial Prevention Technology

Proactively identify potential claim issues before submission. For a detailed comparison of the best billing software for internal medicine, see our guide on Best Medical Billing Software for Internal Medicine Practices.

Implement analytics tools to examine:

• Problematic code pairings
• Historical payer denial patterns
• Documentation deficiencies

Benefit: Advanced analytics help practices identify and correct submission errors earlier in the revenue cycle.

2. Implement Ongoing Staff Education

Maintain team competency through regular training. Conduct monthly sessions covering:

• Current coding standards
• Proper modifier application
• Telehealth billing requirements

Monitor key performance indicators. Target Metrics:

• Denial rate: Industry benchmark <5%
• Clean claim rate: Goal >90%
• AR cycle time: Target <35 days

Best Practice: Combine technology insights with staff training for comprehensive denial management. Systems flag issues while trained specialists implement corrections.

AR & Denials Optimization Checklist for Internal Medicine

Strategy	Tool/Approach	Measurable Benefit
Real-time eligibility verification	Availity, Waystar	Reduces registration-related denials
Accurate documentation & coding	E/M audits, Modifier checks	Minimizes coding-related claim rejections
Pre-submission claim scrubbing	Zirmed, ClaimMD	Improves clean claim submission rate
Weekly AR monitoring	RevFlow, Kareo dashboards	Identifies aging claims for timely follow-up
Payer-specific rule tracking	Maintained internal database	Reveals patterns in denial reasons
Ongoing staff education	Monthly training sessions	Reduces preventable billing errors

FAQ: Internal Medicine AR & Denial Management

What is considered aged AR in internal medicine billing?

Aged AR refers to claims unpaid after 30 days. Internal medicine practices should focus on AR buckets like 31–60, 61–90, and 90+ days to manage cash flow and reduce write-offs.

What is the average AR benchmark for internal medicine practices?

The MGMA benchmark recommends keeping AR >90 days below 10% of total receivables. Internal medicine billing teams should track aging weekly to stay within this target.

Why do internal medicine claims get denied most often?

Common reasons for denial include incorrect E/M coding, missing modifiers, eligibility mismatches, and insufficient documentation. Payer-specific policy changes also contribute to rejections.

Explore the top 10 denial reasons and actionable fixes for each.

How can internal medicine practices reduce claim denials?

Use real-time eligibility checks, accurate CPT/ICD coding, and claim scrubbing tools. Monitor denial trends and train billing staff monthly to reduce rejection rates by up to 45%.

Start with a latest compliance gap analysis to identify vulnerabilities.

What tools help reduce aged AR in internal medicine billing?

Tools like RevFlow, Kareo, and Zirmed automate AR tracking, follow-up scheduling, and denial resolution. These platforms help identify bottlenecks and accelerate collections.

Which CPT codes commonly trigger denials in internal medicine?

Codes like 99213, 36415, 99490, and telehealth services often trigger denials due to modifier errors or documentation gaps. Always check payer-specific rules for each service line.