1. Tiered Follow-Up System
| Days Outstanding | Action |
| 0-30 days | Monitor via payer portals |
| 31-45 days | First follow-up (phone/email) |
| 46-60 days | Escalate to payer rep |
| 60+ days | Formal appeal with documentation |
2. Payer-Specific Tactics
✔ Medicare: Use MAC portal for real-time status
✔ Medicaid: Follow state-specific appeal deadlines
✔ Commercial Payers: Leverage provider reps for stalled claims
3. Proactive Prevention
✔ Pre-Submission Scrubbing – Fix errors before filing
✔ Denial Root Cause Analysis – Address recurring issues
✔ Automated Tracking – Use RCM software alerts
4. Escalation Path
- Portal Inquiry → 2. Phone Call → 3. Provider Rep → 4. Written Appeal
