Practice Overview
A mid-sized orthopedic group operating across two locations in the Midwest, this practice specializes in joint replacement, trauma surgery, and sports medicine. With 10 physicians and consistent patient volume, the clinical side of the operation was running like clockwork.
But behind the scenes, their business office was overwhelmed.
Their AR was growing every month. Claims weren’t being followed up in time. Denials were turning into write-offs. And their monthly cash flow wasn’t matching their productivity.
Their problem wasn’t growth. It was collections.
The Challenge: Aged AR Was Eating Into Revenue
When AnnexMed was brought in, the practice’s AR had become unsustainable:
- AR over 90+ days accounted for 36% of total outstanding receivables
- Denials were up, but only 3 in 5 were actively worked
- AR follow-up processes were inconsistent, handled by a small team juggling multiple roles
- No centralized tracking system, leading to missed deadlines, duplicate touches, and gaps in follow-through
- Cash flow delays were forcing leadership to delay investments in staff, equipment, and expansion plans
AnnexMed’s Assessment
We conducted a 360° AR review in the first 10 days:
- Sorted AR by aging bucket, payer, and procedure type
- Mapped denial patterns and top reasons for claim rejections
- Audited the follow-up activity trail on aged claims
- Analyzed internal team capacity and technology gaps
The Fix: Rebuilding AR Discipline
AnnexMed implemented a strategic collections plan designed for orthopedic revenue cycles:
Specialized AR Team Deployment – We assigned a dedicated 5-member AR team with experience in orthopedic billing. Each agent worked a defined set of payers, CPT codes, and aging buckets, ensuring deep familiarity and faster results.
ResolvAR™ Rollout – AnnexMed’s AR tracking platform was introduced to centralize workflows, eliminate manual logs, and prioritize claims based on recovery value and payer response cycle.
Denial Management Overhaul – We categorized denials by root cause (auth, coding, documentation, bundling, etc.) and created weekly feedback loops with the internal coding and billing team.
Escalation Protocols – All claims untouched beyond 30 days triggered automatic escalations, phone-based follow-ups, second-level appeals, and payer dispute workflows.
Live Dashboards and Client Reporting – Practice leaders could now view real-time AR status, recovery performance, and claim activity, turning guesswork into actionable insight.
Impact in 90 Days
Metric | Before | After |
AR > 90 Days | 36% | 22% |
Clean Claim Rate | 80% | 93% |
Denial Recovery Rate | 21% | 38% |
Claims Touched Within 21 Days | 51% | 90% |
Results Beyond the Numbers
- Stronger cash flow enabled the clinic to move forward with expansion plans
- Fewer write-offs, thanks to proactive follow-up and smarter workflows
- Back-office morale improved, less chaos, more clarity
- Leadership gained visibility, control, and confidence in revenue operations
