Hospitals and health systems face increasing pressure to reduce accounts receivable (A/R) days while improving net collections—especially as payer requirements become more complex and denial rates rise. Complex claim recovery is no longer just a back-end process; it is a key part of a comprehensive denied claims management strategy.

At TGA Solutions, hospitals are supported with specialized recovery services designed for high-effort, high-value accounts. This includes complex claims and third-party recovery for hospitals, ensuring that claims tied to liability, coverage disputes, and delayed documentation do not linger unresolved in your revenue cycle.

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Why Complex Claims Drive Denials (and A/R Days)

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Complex claims are often denied due to avoidable gaps—missing documentation, eligibility issues, coordination of benefits, authorization discrepancies, or payer policy changes. These accounts require more than routine follow-up. They require targeted, experienced escalation that’s aligned with your existing revenue cycle processes.

That’s why strong denied claims management must go beyond appeal submission. It must address the operational reasons denials occur and accelerate resolution through consistent documentation, timely payer communication, and structured prioritization of accounts.

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Third-Party Recovery for Hospitals: Capturing Hidden Revenue

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Many facilities also carry accounts that should not be paid by the patient—or even the original payer—because a third party is ultimately responsible. These may include accounts tied to motor vehicle accidents, liability-related injuries, and other third-party coverage situations. Without focused follow-up and recovery, these claims often fall outside standard workflows, creating long delays in payment or increasing the chance of write-offs.

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TGA Solution’s third-party recovery for hospitals ensures these accounts are identified early, prioritized correctly, and pursued with the documentation and persistence needed to produce measurable cash results.

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A Data-Driven Process That Improves Collections

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TGA Solutions uses proprietary software to analyze accounts using determined metrics—establishing account value, complexity, and likelihood of recovery. From there, accounts are routed to the appropriate recovery specialists. This enables smarter prioritization, faster action, and a more predictable recovery pipeline.

Because complex claim work can be time-intensive, hospitals benefit when accounts are handled by specialists rather than being added to the workload of internal staff who are already managing high volumes. The result is reduced backlog, improved outcomes, and fewer “stale” accounts.

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Real-Time Documentation & Transparent Reporting

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Compliance, transparency, and continuity matter in hospital recovery operations. TGA Solutions documents all account activity in real time within the hospital’s existing system, ensuring that progress is visible and the hospital maintains full oversight. In addition, monthly reporting provides clarity on account aging, recovery movement, and cash outcomes—helping leadership track trends and improve forecast accuracy.

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Faster Cash Without Increasing A/R Days

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The goal is simple: return cash to the hospital faster, reduce unnecessary aging, and prevent avoidable write-offs. By integrating complex claim recovery and denied claims management into one coordinated solution—alongside third-party recovery—TGA Solutions helps hospitals accelerate payments and protect revenue that might otherwise be lost.

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If your organization is looking to strengthen denied claims performance, reduce aging, and improve net collections, TGA Solutions offers decades of experiences and a focused recovery approach built specifically for hospital environments.

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