From a 90 Day AR Trial to Full Revenue Cycle Partner for an Ambulatory Surgery Center
From a 90 Day AR Trial to Full Revenue Cycle Partner for an Ambulatory Surgery Center Home / Blog / From a 90 Day AR Trial to Full Revenue Cycle Partner for an Ambulatory Surgery Center How a four location ambulatory surgery center tested MediCommerce on its hardest AR, then handed over all of its billing within fifteen months Client Snapshot The client is a four location ambulatory surgery center with five providers and an average of 100 visits, collecting around one and a half million dollars a month before MediCommerce entered the picture. The relationship did not start with a full billing handoff. It started with a trial, and the practice made it clear that trust would have to be earned, especially after two earlier attempts to fix the problem had already failed. Two Failed Attempts Before MediCommerce The practice had tried to solve its 180+ AR problem twice before, and neither attempt worked. A third party billing company was managing claims but was, in practice, just letting difficult claims age into the 180+ bucket rather than working them, balances that could have been resolved with the right follow up were instead left to sit and eventually written off. When that outsourced relationship failed to deliver, the practice pulled the work in house, hiring a manager and two team members to take a run at the backlog themselves. That effort did not fare much better. The internal team was sending out bundles of paper appeals with no tracking mechanism to show which claims had been appealed, which were pending, or which had actually resulted in payment. There was no way to measure whether the effort was working, and no real cash was coming back in. By the time MediCommerce was brought in, the practice had already spent time and money on two approaches that left the 180+ AR exactly where it started. The Trial: Proving It on the Hardest AR Given that history, the practice offered MediCommerce a 90 day initial contract with a narrow, difficult scope, two full time resources dedicated to cleaning up 180+ AR that had been sitting for six months or more. This aging bucket totaled around $700,000, the kind of balance most billing teams write off rather than fight for. The owner was not ready to commit to a long term partnership after two prior misses. He wanted proof. MediCommerce’s team spent the first stretch analyzing the denial patterns behind the aging claims, refiling where documentation supported it, and appealing with medical records where insurers had denied in error, with every claim tracked from submission through resolution. Within three months, that focused effort had brought $300,000 in new cash back into the practice, money the owner had largely written off as gone. The turnaround was enough for him to extend the contract for another three months to finish the job. Six Months In: The AR Cleaned Up By the end of the full six month engagement, the entire 180+ AR balance had been worked to resolution. MediCommerce collected 75 percent of the original $700,000, and what remained was analyzed claim by claim and recommended for write off only after every avenue for collection had been exhausted. Nothing was written off by default. The practice ended up with a clean, accurate picture of what was truly collectable and what was not, something neither the prior vendor nor the in house team had ever given them. Earning the Rest of the Business That result changed the relationship. Twelve months into the engagement, the owner handed MediCommerce full billing services for one of his four locations, moving from a narrow AR cleanup project to complete revenue cycle ownership. The performance at that single location made the decision easy, and within three more months, by month fifteen, all four locations had transitioned their billing to MediCommerce. From Unpredictable to Reliable Beyond the aging AR, the practice had a deeper problem with its prior vendor, even collections on claims under 180 days had no consistency. One month the practice would collect $1.4 million, the next it would drop to $900,000 with no pattern and no way to plan around it. That kind of swing made it difficult for the owner to make confident decisions about staffing or expanding the business, since he could never be sure what the practice would actually collect from one month to the next. Once MediCommerce took over full billing, that unpredictability disappeared. Monthly collections settled into a reliable range of $2 million to $2.1 million, month after month, giving the owner a dependable number to plan around for the first time. The Results at Full Scale Once MediCommerce owned the full revenue cycle across all four locations, the same discipline that cleared the original AR backlog was applied every day going forward. Charts were billed within two working days of being signed, appointment reconciliations caught unbilled visits weekly, claim edits and rejections were worked daily, and denials were resolved within two working days of being captured. AR aging claims were followed up on a consistent thirty day cycle, with a shared dashboard giving the practice full visibility into billing performance, staffing, and collections for the first time. From the sixteenth month onward, the practice has collected no less than $2 million a month, 25 percent above what it was averaging before MediCommerce took over. 52 days average AR across the practice today 5 to 7 percent of AR sitting past 120 days 94 percent first pass payment rate What started as a 90 day trial on the hardest AR in the practice, after two earlier attempts had already failed, became a full four location partnership with predictable, growing collections, built entirely on proof rather than promises. 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