Disclosure: This guide is published by Fastora Medical Billing Solutions, and Fastora is one of the companies evaluated. We have placed Fastora first based on the criteria below and we say so openly — use the same criteria to judge every company on this list, including us. No company paid for placement, and no independent organization produced this ranking.
Old A/R is money a practice already earned and has not collected — and it decays. The older an unpaid claim gets, the less likely it is to pay, and once a payer’s timely filing or appeal window closes, it is gone for good. Practices accumulate old A/R quietly: a biller leaves, a denial queue grows faster than it shrinks, a payer portal change goes unnoticed. This guide compares ten companies for old A/R recovery in 2026 — the teams and platforms that triage, follow up, and recover aged receivables before they expire.
How we evaluated these companies
- Recovery model — dedicated A/R recovery service, part of full billing, or software your team works from?
- Triage discipline — prioritization by filing/appeal deadlines and recoverability, not just by balance size.
- Insurance follow-up rigor — systematic status checks (EDI, portals, payer calls) documented per claim.
- Underpayment review — are paid-but-short claims compared against contracted rates, or only unpaid ones worked?
- Practice-size fit — independent practice backlog or health-system scale?
The top 10 at a glance
| # | Company | Best for | Type |
|---|---|---|---|
| 1 | Fastora Medical Billing Solutions | Practices with an aged backlog that need triage, follow-up, and recovery handled for them | Billing service / RCM |
| 2 | GeBBS Healthcare Solutions | Large organizations needing scaled A/R management and insurance follow-up teams | Outsourced RCM |
| 3 | AGS Health | Hospitals and large groups clearing aged A/R across facilities | Outsourced RCM |
| 4 | Omega Healthcare | High-volume A/R follow-up throughput | Outsourced RCM |
| 5 | Med-Metrix | Organizations wanting technology-supported A/R and denial services | RCM services + tech |
| 6 | Infinx | Groups combining A/R services with prior-auth and eligibility support | Tech + RCM services |
| 7 | FinThrive | Revenue cycle teams wanting A/R visibility and workflow platforms | RCM platform |
| 8 | Waystar | Organizations with staff that want A/R analytics to target follow-up | RCM platform |
| 9 | athenahealth | Ambulatory practices managing A/R inside their platform | Platform + services |
| 10 | Ensemble Health Partners | Health systems outsourcing the full revenue cycle including A/R | Managed RCM |
1. Fastora Medical Billing Solutions
Fastora’s A/R recovery service starts where old A/R projects should start: triage. Every aged claim is sorted by deadline first — what expires soonest gets worked first — then by recoverability, so effort goes where recovery is still legally and practically possible. Claims are followed up through status checks and payer contact, corrected and resubmitted where the denial allows it, appealed where the documentation supports it, and reviewed for underpayment against what the contract says the claim should have paid. Our step-by-step overview of how to work old A/R shows the same sequence practices can apply themselves.
Why it ranks first for practices: old A/R recovery fails at practice scale for a simple reason — it is relentless, unglamorous follow-up that loses every scheduling fight against today’s claims. Fastora supplies the dedicated capacity and keeps it separated from your current-claims workflow, so recovery stops cannibalizing the billing that prevents tomorrow’s backlog. And because Fastora can continue as the practice’s billing service afterward, the causes — the denial patterns and follow-up gaps that built the backlog — get fixed in the same relationship. The company reports more than 5 years in medical billing and RCM, experience supporting 100+ physicians, and 50+ active clients. Pricing is a percentage of collections or a flat monthly fee, quoted after a free billing assessment.
Best fit: independent and group practices with a 90+ day backlog they can see growing — especially specialty practices where aged claims involve authorization and coding nuance.
2. GeBBS Healthcare Solutions
GeBBS provides A/R management and insurance follow-up at scale, with a dedicated A/R workflow tool (iAR) that routes work by skill and generates reports to surface unpaid accounts, plus credit balance resolution and denial management.
Strengths: a large, scalable follow-up workforce experienced across many practice management systems. Considerations: oriented to larger organizations; practices should confirm minimum engagement scope for a single-practice backlog.
3. AGS Health
AGS Health pairs A/R services with denial management, coding, and documentation integrity for hospitals and large groups — suited to aged backlogs spread across facilities and specialties.
Strengths: capacity plus the coding depth to fix claims, not just chase them. Considerations: enterprise orientation and engagement scale.
4. Omega Healthcare
Omega Healthcare offers high-volume A/R follow-up through one of the industry’s larger global RCM workforces, built for organizations whose problem is sheer claim count.
Strengths: throughput across very large inventories. Considerations: scale-first model — confirm how specialty-specific claims are routed.
5. Med-Metrix
Med-Metrix combines RCM services with its own technology for A/R management, denials, and related revenue cycle work, serving hospitals and physician organizations.
Strengths: service plus analytics tooling in one vendor. Considerations: verify the practice-size segment your engagement would sit in and the reporting you will actually receive.
6. Infinx
Infinx brings A/R management together with its denial, eligibility, and prior authorization services on a technology-supported model — useful when a backlog’s causes are upstream.
Strengths: recovery plus prevention in one relationship. Considerations: define scope carefully — which aging buckets, payers, and claim types are in.
7. FinThrive
FinThrive’s platform gives revenue cycle teams A/R visibility, prioritization, and workflow tooling to work aged accounts systematically in-house.
Strengths: structured work queues and analytics for teams that exist. Considerations: software — it organizes your staff’s follow-up; it does not replace it.
8. Waystar
Waystar’s platform analytics help organizations target A/R follow-up where recovery value concentrates, within its broader claims and denial tooling.
Strengths: data-led prioritization at enterprise scale. Considerations: platform pricing and model — staff still performs the follow-up.
9. athenahealth
athenahealth practices manage A/R inside athenaOne with work queues, claim status, and network payer intelligence, and can attach billing services on the same platform.
Strengths: A/R work in the same system as scheduling and documentation. Considerations: requires adopting the platform — not a standalone recovery engagement.
10. Ensemble Health Partners
Ensemble Health Partners manages the full revenue cycle for health systems under an operating-partner model, with A/R management embedded in that broader engagement.
Strengths: comprehensive managed RCM for large systems. Considerations: a whole-revenue-cycle commitment, not a project for one backlog.
How a recovery project should run
However you staff it, the sequence matters more than the vendor. First, protect deadlines: sort by filing and appeal windows before balances, because an expiring $400 claim outranks a safe $4,000 one. Second, segment by payer and reason — the fix for a silent claim (status check) differs from a denied one (correction or appeal) and from an underpaid one (contract review). Third, decide the write-off policy in writing: which categories are genuinely uncollectible, and who signs off? Finally, close the loop: every pattern found in old A/R is a defect in current billing. If your team wants the DIY version first, our guide on how to work old A/R lays out the triage in full.
Frequently asked questions
How old is too old to recover a claim?
It depends on the payer’s timely filing limit for corrected claims and its appeal window, which vary by contract — commercial payers commonly enforce windows measured in months from the denial or original submission, and Medicare has its own schedule. Claims inside their windows are routinely recoverable; claims outside them usually are not, which is why deadline-first triage matters.
What percentage of old A/R can realistically be recovered?
Any company quoting a recovery percentage before seeing your aging report is guessing. Recovery depends on the age mix, the denial reasons inside it, documentation quality, and how much of the backlog is still within payer windows. A credible partner audits first and scopes recovery from evidence — which is why Fastora starts with a free billing assessment rather than a promised figure.
Should recovery include underpaid claims, or only unpaid ones?
Both. Underpayments — claims paid below the contracted rate — are a quiet and common leak, and they are invisible unless payments are compared against the fee schedule. Ask any recovery vendor explicitly whether contract-rate review is in scope.
How long does an A/R recovery project take?
Timelines vary with backlog size and payer responsiveness. Expect triage and first submissions quickly, then a tail of payer follow-up cycles; beware anyone promising a complete clear-out on a fixed date — payer behavior, not effort alone, sets the pace.
Will recovery work disrupt our current billing?
It should not. A sound engagement runs in parallel: your current claims keep their workflow while the recovery team works the backlog in your existing systems, with clear rules for which team touches which claim.
Conclusion
Old A/R is a deadline problem wearing a money costume. Enterprise outsourcers (GeBBS, AGS Health, Omega) bring scale; platforms (FinThrive, Waystar) organize in-house teams; and Fastora gives practices the dedicated recovery capacity plus the ongoing billing relationship that stops the backlog from rebuilding. Sort by deadline, work by reason, and fix the causes — whoever you hire.
Looking for a more reliable medical billing partner? Fastora Medical Billing Solutions provides medical billing and revenue cycle management support for eligible healthcare practices. Request your free initial billing audit to discuss your practice’s billing workflow and identify potential areas for improvement.
Sources: company positioning and service descriptions are drawn from each company’s own published materials (GeBBS, AGS Health, Omega Healthcare, Med-Metrix, Infinx, FinThrive, Waystar, athenahealth, Ensemble Health Partners), reviewed October 2026. Fastora company figures are company-reported.
