Glen Matheson sought proposals from several third-party organizations before selecting Medientsky Billing.

According to the revenue cycle director, Medientsky’s experience handling similar AR projects and its operational approach were important factors in the decision.

Another key consideration was AR Analyzer, Medientsky Billing’s proprietary AR management software.

The organization needed more than a conventional follow-up process. Its AR portfolio required a way to identify the most important receivables, organize work according to risk, and help the revenue cycle team focus its efforts where recovery opportunities were strongest.

The Solution

Medientsky Billing developed a multi-step AR recovery strategy focused on bringing legacy receivables under control while simultaneously addressing the coding backlog.

The approach included:

• AR wind-down services for payer and patient AR
• Lost Revenue Recovery Audit (LRRA)
• Identification of collectible AR
• Prioritization of high-risk receivables
• AR follow-up and resolution
• Coding backlog support
• Preservation of AR asset value
• Ongoing monitoring of current receivables

1. Lost Revenue Recovery Audit

The engagement began with an extensive Lost Revenue Recovery Audit (LRRA).

The audit was designed to identify deficiencies across the existing revenue cycle and determine where opportunities existed to recover outstanding revenue.

Medientsky Billing used the findings to develop recommendations covering both coding and AR management.

The objective was twofold:

1. Establish a practical recovery path for older AR.
2. Help bring pending coding work and current claims closer to resolution.

This created a foundation for addressing the existing backlog without losing sight of ongoing revenue cycle activity.

2. Identifying Collectible AR

The first operational step was to determine which outstanding accounts remained collectible.

Medientsky Billing evaluated receivables using multiple parameters, including insurance filing limits and appeal limits, and compared those requirements against the age and status of outstanding AR.

This helped separate receivables that still had a viable recovery opportunity from balances that had moved into higher-risk or uncollectable categories.

The goal was not simply to work the oldest accounts first. The AR needed to be organized according to recovery potential and urgency.

3. Prioritizing the Work Queue

After identifying collectible accounts, Medientsky Billing organized the work according to priority.

Immediate-priority claims were addressed first to support faster recovery and reduce the risk of otherwise collectible claims moving into uncollectable buckets.

This approach allowed the AR team to concentrate its efforts on receivables where timely intervention could make the greatest difference.

4. Reviewing Older and Difficult AR

The next stage focused on older AR that initially appeared difficult to collect.

Medientsky Billing reviewed these balances and looked for viable points of contact within insurance organizations to determine whether additional recovery opportunities existed.

This included reviewing bulk claims and overlooked pockets of revenue that may not have received sufficient attention during previous AR follow-up efforts.

Rather than treating every aged account in the same way, the recovery process focused on understanding the characteristics and risk associated with each segment.

AR Analyzer and Risk-Based Work Allocation

A central component of the solution was AR Analyzer, Medientsky Billing’s proprietary AR management software.

According to the case study, AR Analyzer reduces the time and cost involved in AR management by automatically isolating high-risk receivables.

The system categorizes AR according to financial risk, helping streamline the follow-up process.

This risk-based approach allowed Medientsky’s AR resolution experts to focus on the segments requiring the most attention.

AR Analyzer’s prescriptive work-listing engine also allocated work to receivables management teams based on their experience handling similar AR issues.

Instead of relying on a generalized work queue, the team could focus on specific risk segments and the types of AR issues they were equipped to resolve.

Identifying Overlooked Revenue

A detailed review of the healthcare system’s AR information helped Medientsky Billing identify several overlooked pockets of revenue.

Critical AR issues were surfaced through the system and assigned for resolution.

This was particularly important for a healthcare organization with a large and diverse AR portfolio. With millions of dollars outstanding, even smaller overlooked segments could represent meaningful recovery opportunities.

The combination of AR analysis, risk categorization, prioritized work allocation, and dedicated follow-up created a more structured approach to legacy AR recovery.

Bringing Legacy AR Under Control

The broader objective of the engagement was to bring the healthcare system’s outstanding AR closer to current status while strengthening the processes supporting future revenue.

Medientsky Billing’s AR resolution team worked on key risk segments while providing ongoing AR follow-up.

The approach addressed both sides of the problem:

Legacy AR:
Identify collectible balances, prioritize recovery opportunities, investigate difficult accounts, and pursue overlooked revenue.

Ongoing AR:
Support current receivables and reduce the likelihood that collectible balances would continue aging without appropriate follow-up.

The case study states that Medientsky Billing’s 24/7 AR follow-up services supported the healthcare organization in recovering revenue associated with inefficient and poorly monitored AR processes.