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8% Higher Collections Through a Flexible RCM Delivery Model

Overview

A growing healthcare organization was managing increasing claim volumes across multiple locations and payer contracts. Its internal revenue cycle team was performing well in several areas, but pressure was building unevenly across billing, denials, AR follow-up, eligibility exceptions, and coding overflow.

The organization was not looking to outsource its entire revenue cycle. It needed additional capacity in selected workflows without replacing its existing team, changing technology, or disrupting functions that were

AnnexMed was brought in to provide targeted support where workloads, turnaround times, and aging inventory required additional attention.

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    Engagement Snapshot

    Operating model

    Multi-location healthcare organization

    Initial scope

    Billing, denials and AR follow-up

    Expanded support

    Eligibility and coding overflow

    Payer mix

    Commercial, Medicare and Medicaid

    Technology model

    Existing client EHR/PMS and clearinghouse

    Transition approach

    Phased rather than full RCM migration

    AnnexMed’s Phased Model

    Rather than migrating every revenue cycle function at once, responsibilities were separated into three categories.
    Workflow Client Team AnnexMed Shared Control

    Patient scheduling

    -

    -

    Eligibility exception work

    -

    Prior authorization*

    -

    -

    Coding overflow

    -

    Claim submission

    -

    -

    Rejection correction

    -

    -

    Denial follow-up

    -

    Current AR follow-up

    -

    -

    Aged AR

    -

    -

    Payment posting

    -

    -

    Reporting & escalation

    -

    -

    *Existing client workflow remained in place.

    RCM Work Routing

    90 Day Transition Plan

    Days 1–30 | Stabilize

    The first month focused on establishing workflow control rather than immediately expanding scope. Existing queues were segmented, payer and client rules were documented, access and escalation paths were established, and baseline performance was measured.

    Primary objective:

    Prevent new work from adding to existing backlogs.

    Days 31–60 | Correct

    Once daily volumes were under control, attention shifted toward recurring exceptions. Denial categories were analyzed, rejected claims were separated from true denials, aging accounts were prioritized by recoverability, and repeat upstream issues were routed back to the appropriate teams.

    Primary objective:

    Reduce repeat work rather than simply increase follow-up volume.

    Days 61–90 | Expand

    Additional support was introduced only where the performance data justified it. Coding overflow and eligibility exception queues were added without changing workflows that remained effectively managed internally.

    Primary objective:

    scale selectively instead of outsourcing by default.

    What Changed in the Numbers

    Metric

    Baseline

    After Stabilization

    Change

    Clean claim rate91.2%95.6%+4.4 pts
    90+ day AR21.8%17.3%-4.5 pts
    Denial inventory1,140 claims890 claims-22%
    Average denial follow-up lag8.4 days5.6 days-2.8 days
    Collections*Baseline18% higher+18%

    *Measured against the agreed baseline period after workflow stabilization.

    Proven RCM expertise. Delivered at scale.

    For over 20 years, AnnexMed has delivered RCM solutions nationwide, combining expert billing, coding, and AR support to drive measurable results and growth.

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