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.
Engagement Snapshot
Multi-location healthcare organization
Billing, denials and AR follow-up
Eligibility and coding overflow
Commercial, Medicare and Medicaid
Existing client EHR/PMS and clearinghouse
Phased rather than full RCM migration
AnnexMed’s Phased Model
Client Team
Retained FunctionsAnnexMed
Managed RCM FunctionsShared Control
Collaborative Oversight*Existing client workflow remained in place.
RCM Work Routing
How the Work Actually Moved
A structured workflow ensured consistent, accountable and quality-driven output.
Claims, work queues, payer requirements and clinical documents received and ring-fenced.
Work assigned by urgency, payer, SLA and complexity with clear ownership and queues.
Dedicated teams process and validate claims, ensuring accurate coding and timely submission.
Management
Claims requiring attention routed to subject matter experts for resolution and re-submission.
Defined checklists and multi-level reviews ensure compliance, accuracy and consistent output.
Performance insights shared with stakeholders to identify trends and improve outcomes.
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
*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.
- 20+ years of proven healthcare RCM experience
- 2,000+ professionals supporting billing, coding & AR
- 500+ certified coders across multiple specialties
- 99%+ compliance with HIPAA and security standards
- All 50 states served with consistent, scalable operations
