Frequently Asked Questions

RitzeeCare specializes in insurance accounts receivable recovery and denial management. Our work may include reviewing outstanding insurance balances, researching claim status, communicating with payers, documenting payment barriers, coordinating appropriate next steps, and reporting account outcomes.

RitzeeCare currently focuses on A/R recovery and denial management. We can work alongside a practice’s internal staff or existing billing company under a clearly defined division of responsibilities.

RitzeeCare works with healthcare practices that need focused assistance with outstanding insurance balances or unresolved claim denials. We review the practice’s specialty, account volume, systems, and service needs during the introductory consultation to determine whether the engagement is a suitable fit.

Our primary service focuses on outstanding insurance balances. The accounts included in an engagement are defined in the service agreement before work begins.

Yes, older insurance accounts can be reviewed to determine their status and available next steps. Recovery depends on claim age, timely-filing and appeal deadlines, documentation, payer requirements, prior activity, coverage, and account status.

Depending on account volume and condition, we may provide support for a defined cleanup project or an ongoing engagement. We discuss the appropriate structure after learning about your practice’s needs.

Depending on the agreed scope, we may review denials involving eligibility or coverage, authorization, missing information, coordination of benefits, timely filing, demographic errors, duplicate claims, noncovered services, and payer processing issues. Clinical and coding decisions remain with the practice and its qualified professionals.

Appeal responsibilities depend on the service agreement, payer requirements, available documentation, and authorization from the practice. When an appeal requires clinical judgment, coding decisions, or provider documentation, we coordinate with the practice’s authorized professionals.

RitzeeCare can work alongside internal billing personnel or an existing billing company. Responsibilities, communication procedures, and account ownership are defined before work begins to reduce duplication and confusion.

The process begins with an introductory discussion about your A/R, denial volume, current workflow, and service needs. If both parties decide to proceed, we define the scope, complete the required agreements, establish authorized system access, and agree on communication and reporting procedures.

Onboarding time depends on the scope of work, system-access requirements, account volume, required agreements, and the practice’s readiness. A projected schedule is provided after these details are reviewed.

System compatibility is confirmed during the introductory consultation. RitzeeCare evaluates the access requirements, payer resources, and workflow associated with the practice’s current system before accepting the engagement.

Requirements vary by engagement and may include authorized access to applicable billing systems, A/R or denial reports, relevant payer information, workflow contacts, and supporting documentation. Sensitive information is exchanged only through an approved process after the appropriate agreements are in place.

Depending on the engagement, reporting may include accounts reviewed, completed follow-up actions, payer responses, current statuses, identified barriers, items requiring practice attention, deadlines, and account outcomes.

The reporting schedule is established during onboarding. The frequency may vary based on account volume, engagement scope, and the practice’s operational needs.

Pricing depends on the service selected, account volume, claim age, complexity, expected workload, and engagement structure. Applicable fees and exclusions are explained in writing before work begins.

Yes. RitzeeCare currently offers contingency-based pricing for eligible A/R recovery and denial management engagements. Our fee is calculated as an agreed percentage of the revenue successfully recovered through our work.

The applicable percentage, eligible accounts, exclusions, payment terms, and method for attributing recovered revenue are clearly defined in the service agreement before work begins.

No. Payment and denial outcomes depend on payer rules, coverage, timely-filing and appeal limits, documentation, coding accuracy, authorization requirements, prior claim activity, and other factors outside RitzeeCare’s control.

RitzeeCare establishes information-handling requirements, authorized access, and appropriate agreements before receiving protected health information. Specific safeguards and responsibilities are addressed during onboarding and in the applicable contracts.

When RitzeeCare will create, receive, maintain, or transmit protected health information on behalf of a covered entity, the applicable Business Associate Agreement requirements are addressed before access begins.

No. The public contact form is only for general business inquiries. Do not submit patient names, dates of birth, claim numbers, insurance identifiers, medical records, or other protected health information. Approved clients receive separate instructions for secure information exchange.

Complete the consultation form or contact RitzeeCare by phone or business email. Provide only general information about your practice and the type of support you need. We will follow up to discuss fit, scope, pricing, and next steps.