Accounts Receivable (AR) is the lifeblood of any healthcare organization. However, many hospitals and physician practices struggle with stuck legacy AR—aging claims that remain unpaid due to denials, administrative errors, or inefficiencies. One regional hospital faced a backlog of $1.2M in unpaid AR, creating financial strain and operational inefficiencies.
At Medical Billers and Coders (MBC), we specialize in AR recovery and revenue cycle optimization. Our team took on the challenge of implementing a structured and data-driven approach that successfully recovered the entire $1.2M in legacy AR. In this article, we’ll break down our proven 5-step process, key takeaways, and how hospitals can prevent AR from accumulating.
Understanding Legacy AR and Its Impact on Healthcare Providers
What is Legacy AR?
Legacy AR refers to outstanding claims pending for more than 90 days, often due to insurance denials, billing errors, or lack of follow-ups.
Common Causes of Stuck Legacy AR
- Claim denials and underpayments
- Incorrect medical coding or missing documentation
- Slow or inefficient follow-up processes
- Insurance company disputes and policy changes
- Lack of AR tracking and reporting tools
The Financial and Operational Impact
- Cash Flow Disruptions: Unresolved AR ties up revenue, affecting hospital operations.
- Compliance Risks: Billing errors can lead to audits and penalties.
- Administrative Burden: Staff spends excessive time chasing payments instead of optimizing patient care.
The $1.2M Challenge – A Case Study Overview
A 400-bed regional hospital approached MBC with a major problem—$1.2M in unresolved AR, some claims dating back over 12 months. The hospital’s in-house billing team was overwhelmed, struggling to keep up with payer demands, appeals, and follow-ups.
Initial Assessment
- Aging claims were categorized based on payer, denial reason, and claim status.
- High-value claims were prioritized for immediate resubmission and appeal.
- A customized AR recovery strategy was designed, integrating technology and expert intervention.
Our Proven 5-Step Process to Recovering Stuck Legacy AR
At MBC, we follow a structured approach to analyze, prioritize, and recover outstanding claims.
Step 1 – Advanced AR Segmentation and Prioritization
- Grouped AR based on aging buckets (90–120 days, 120–180 days, 180+ days).
- Focused on high-value claims that had the highest probability of recovery.
- Identified payers with high denial rates to streamline follow-up efforts.
Step 2 – Specialized Claim Resubmission and Appeals Handling
- Corrected coding errors and resubmitted claims with appropriate modifiers.
- Gathered supporting documentation to strengthen appeals.
- Appealed underpaid claims by analyzing contract terms with payers.
Step 3 – Direct Payer Negotiations and Follow-Ups
- Engaged directly with payer representatives for claim resolution.
- Expedited processing by leveraging payer relationships and escalation protocols.
- Negotiated settlements for partially paid claims to maximize recovery.
Step 4 – Technology-Enabled AR Automation and AI Tools
- Automated claim tracking to identify missing payments in real time.
- Used AI-driven analytics to flag problematic claims before they become uncollectible.
- Integrated an automated follow-up system to reduce manual efforts.
Step 5 – Proactive Compliance Audits and Process Optimization
- Conducted billing and coding audits to identify recurring errors.
- Trained hospital staff on compliance updates and best practices.
- Implemented ongoing AR monitoring to prevent future backlogs.
Results – Breaking Down the $1.2M Recovery Success
Key Achievements
- $1.2M recovered within 6 months
- 85% success rate in claim resubmission and appeals
- 50% reduction in outstanding AR over 90 days
- Improved cash flow, allowing reinvestment in hospital operations
Timeline of Recovery – How Long Did It Take?
| Recovery Phase | Time Taken |
| AR Analysis & Segmentation | 2 Weeks |
| Claim Resubmission & Appeals | 8 Weeks |
| Payer Negotiations & Follow-ups | 10 Weeks |
| Final Compliance Audit | 2 Weeks |
How MBC Can Help Your Hospital Overcome Legacy AR Challenges
Hospitals struggling with legacy AR need specialized expertise and data-driven strategies. At MBC, we offer:
- Dedicated AR specialists for claim resolution
- Technology-driven tracking for real-time updates
- Proactive compliance audits to prevent future denials
- Custom strategies tailored to your hospital’s needs
Want to recover your stuck AR and improve revenue? Schedule a consultation today!
FAQs About Legacy AR Recovery
Q1: How long does it take to recover aged AR?
It depends on claim complexity, but our structured approach recovers AR within 3-6 months.
Q2: Can you recover claims older than 12 months?
Yes, though success rates depend on payer policies and claim documentation.
Q3: What if my hospital lacks internal billing resources?
MBC provides end-to-end revenue cycle management, including claim submission, appeals, and AR follow-ups.
Q4: Do you work with all specialties?
Yes! We handle AR recovery for multiple specialties, including OB-GYN, Dermatology, Optometry, and Orthopedics.
Q5: How does MBC ensure compliance in AR recovery?
We follow HIPAA-compliant procedures, conduct audits, and ensure all claims meet payer guidelines.
Q6: What makes MBC different from other billing services?
Our dedicated account managers, real-time reporting, and AI-driven workflows set us apart.
Conclusion – Transform Your AR into Revenue with MBC
$1.2M recovered, streamlined revenue, and reduced administrative burden—this is what MBC delivers. If your hospital struggles with legacy AR, we have the expertise to recover your revenue efficiently.
Take the first step toward maximizing your collections. Schedule a consultation today!
