Facility AR Follow-Up

Facility AR Follow-up That
Actually Gets Paid

Active facility AR follow-up with skilled nursing, assisted living, and intermediate care facility business offices — with the cadence-based outreach, business office relationship discipline, and aging escalation logic LTC pharmacy actually needs.

< 12%

AR Over 90 Days

< 45

Days DSO

96%+

Facility Collection Rate

The Reality

Why Facility AR Quietly Becomes the Single Biggest Cash Drag on LTC Pharmacy?

Facility AR Gets Deprioritized

Facility-billed claims sit in a different category than payer claims. LTC pharmacy billing teams routinely prioritize payer claim recovery and let facility AR age, because facility business offices feel like relationship work rather than collection work.

Business Office Capacity Varies

Facility business offices range from highly responsive to chronically understaffed. A pharmacy serving 40 facilities is dealing with 40 different business office cadences, 40 different financial controllers, and 40 different willingness-to-pay profiles.

Statement Generation Is Not Collection

Most LTC pharmacy billing operations generate facility statements and stop. Without active follow-up, escalation triggers, and aging-window discipline, statements get filed without payment for 60, 90, 120 days at a time.

Census Reconciliation Disputes

Facility AR disputes often trace back to census reconciliation issues — patients billed after discharge, missed hospice elections, or insurance changes not communicated to the pharmacy. Without active census reconciliation, AR disputes accumulate.

Family Billing Complexity

When facility billing fails — bankruptcy, contract dispute, ownership change — patient and family billing becomes the recovery path. Most LTC pharmacy operations are not set up for compassionate collections on family-billed balances.

Cash Impact on Pharmacy Operations

Aged facility AR directly hits LTC pharmacy working capital. A pharmacy with $4M in facility AR aged beyond 90 days is carrying that cash impact while still funding ongoing operations — a structural margin drag.

Recent Client Results

Proof From The Field

A regional closed-door pharmacy serving 60 SNFs improved facility AR over 90 days from 34% to 11% within four months and reduced overall days in A/R from 78 to 41 through cadence-based facility outreach and aging escalation. A multi-state LTC pharmacy serving 4,200 beds across 7 states recovered $1.1M in aged facility AR through systematic business office engagement and family billing conversion. A combination LTC and assisted living pharmacy reduced facility statement-to-payment cycle from 67 days to 28 days by implementing structured follow-up cadence with controller-level contact tracking.

< 12%

Facility AR Over
90 Days

< 45 days

Facility AR Days Sales
Outstanding

96%+

Facility AR Net
Collection Rate

How we support you

End-to-End Facility AR Recovery

AnnexMed runs facility AR follow-up as a three-stage operation — statement and routine follow-up, escalation and dispute resolution, and family billing conversion — so facility balances get paid on time, disputes get resolved at the business office level, and unrecoverable facility AR converts to family billing instead of write-off.

Statement & Cadence

Routine billing operation

Escalation & Disputes

Aging recovery and resolution

Family Billing Conversion

Recovery when facility billing fails

Financial impact

What These Improvements Mean in Dollars?

For a mid-size LTC pharmacy with $25M–$60M in annual facility billings, dedicated facility AR follow-up regularly delivers $400K–$1.5M+ in net annual financial benefit through aged AR recovery, days-in-AR reduction, and family billing conversion on otherwise written-off balances. Most LTC pharmacies achieve full ROI on facility AR operations within 4–6 months.

Improvement Area

Estimated Annual Impact

Aged Facility AR Recovery (first 6 months)

$300K – $1M in one-time historical recovery

Days-in-AR Reduction (78 → 41 days)

$400K – $1.5M in freed working capital

Net Collection Rate Improvement

$200K – $700K annually in recovered facility revenue

Family Billing Conversion Recovery

$100K – $400K annually in previously written-off balances

Census Reconciliation Dispute Resolution

$80K – $300K annually in resolved billing disputes

Contract Rate Verification Recovery

$60K – $250K annually in underpaid facility claims

Staffing Cost Reduction

$180K – $450K annually

Performance Targets vs. Industry Benchmark

KPIs we hold ourselves accountable to — tracked in real time through your operational dashboards:

Performance Metric

Industry Benchmark

AnnexMed Target

Facility AR Over 90 Days

LTC industry avg: 28–38%

< 12%

Days in Facility AR

LTC industry avg: 65–85 days

< 45 days

Facility Net Collection Rate

LTC industry avg: 87–91%

96%+

Statement-to-Payment Cycle

LTC industry avg: 55–75 days

< 30 days

Family Billing Conversion Rate

LTC industry avg: 25–40%

70%+

Aged AR Recovery Rate

LTC industry avg: 18–28%

65%+

Business Office Outreach Cadence

Industry standard: Statement-only

Scheduled by aging

Census Reconciliation Cadence

Industry standard: Weekly or monthly

Daily

Why Annexmed?

In-House vs. AnnexMed Partnership

Facility AR follow-up is where LTC pharmacy working capital gets recovered or absorbed. Here’s how AnnexMed compares to typical in-house or generalist billing operations:

In-House / Traditional

AnnexMed Partnership

Follow-up Cadence

Statement-only; passive aging

Cadence-based outreach by aging window with escalation triggers

Business Office Engagement

Reactive; only on disputes

Active controller-level relationship tracking and engagement

Census Reconciliation

Weekly or monthly; disputes accumulate

Daily reconciliation pre-statement, preventing dispute origination

Aged AR Treatment

Aged > 90 days routinely written off

Six-month historical sweep with recovery prioritization

Family Billing

Often unstaffed; balances written off when facility billing fails

Compassionate collections operation with payment plan coordination

Contract Rate Verification

Limited; underpayments absorbed

Continuous contract rate verification with discrepancy recovery

Aging Reporting

Quarterly; reactive

Real-time aging dashboards by facility with proactive alerts

Cost to Operate

$50K–$80K per FTE; high turnover on collections work

30–40% lower with no hiring, attrition, or training overhead

Real cost example: LTC pharmacy serving 80 facilities and 3,800 beds with $32M facility billings annually

In-House: $360,000 annual cost (4 FTE facility AR + family billing coordinator + statement software) + estimated $1.4M annual cash impact (aged AR carry cost, write-offs on family billing failures, contract rate underpayments, census dispute losses). AnnexMed: $215,000 annual partnership fee + projected $1.7M annual financial benefit (aged recovery, DSO reduction, family billing conversion, dispute resolution, contract rate recovery) = net annual financial benefit of approximately +$1.5M per year, plus structural working capital improvement.

Technology

Powered by proprietary AI & analytics

AnnexMed’s technology stack was built for payer-specific operational demands, not adapted from provider-side billing tools. Risk adjustment accuracy, payment integrity, and credentialing compliance each require different data models, workflow logic, and reporting architectures than provider RCM. Our platform reflects that.

AI Agents & Automation

AI Agents & Intelligent Automation deploys autonomous AI agents across the full revenue cycle, automating eligibility verification, prior authorization, claims processing, payment posting, and denial management at hospital scale and speed.

Data & Analytics Platform

Data & Analytics Platform delivers real-time Power BI dashboards built for hospital executive visibility, including system-wide KPIs, service line performance, payer analysis, productivity, financial forecasting, and national benchmarking insights.

Intelligent AR Management

Intelligent AR Management handles A/R follow-up at hospital scale with intelligent worklists prioritized by dollar value and aging, payer-specific follow-up rules, automated escalation for high-value accounts, and full accountability for every claim.

Computer Assisted Coding

Computer Assisted Coding orchestrates hospital coding operation, intelligent chart assignment by service line, TAT tracking with SLA monitoring, quality audits with accuracy scoring, and coder performance management at enterprise scale.

Together, these platforms create a fully instrumented RCM operation where nothing falls through the cracks. You don’t interact with these systems directly, but the results they enable show up directly in your financial performance.

Ready to Stop Carrying Aged Facility AR as a Margin Drag?

Most LTC pharmacies identify $400K–$1.2M in recoverable facility AR and working capital from follow-up discipline alone — with parallel structural improvement to days in AR. Schedule a no-obligation Facility AR Audit.

Trusted by 100+ Healthcare Providers | AAPC, AHIMA & AAHAM Certified | SOC 2 Type II | HIPAA Compliant

Payer client outcomes

AnnexMed delivers measurable financial impact within the first 60 to 90 days of engagement. The following represent outcomes from active payer partnerships:

$15M–$40M

Risk
Adjustment

$18M–$50M

Payment
Integrity

6 Weeks

Credentialing Clearance

$15M–$50M+

Revenue
Impact

Case Studies

See the impact we deliver

Discover how AnnexMed reduces denials, accelerates reimbursements, and strengthens financial performance. Backed by measurable outcomes and proven RCM expertise, we deliver operational excellence, revenue stability, and sustainable growth you can trust.

Client Voices

See how our clients succeed

Hear from organizations that trust AnnexMed to reduce denials, accelerate reimbursements, and strengthen cash flow. Our expert support delivers measurable performance gains, operational efficiency, financial stability, and scalable growth.

Claims adjudication backlogs were delaying provider payments and increasing complaint volumes. AnnexMed took over processing, cleared the backlog in 30 days, and improved turnaround by 45%. Provider satisfaction scores climbed significantly, dispute volumes dropped, and our network relationships strengthened significantly.

Dr. Richard Calloway

Horizon Health Plan

Our payer operations team was overwhelmed with member inquiries, provider disputes, and claims rework. AnnexMed brought dedicated support that handled every function with accuracy and speed. Processing errors dropped by 60%, provider abrasion decreased, and our operational costs came down by nearly a third.

Dr. Priya Menon

Crestview Insurance Partners

Managing claims accuracy, provider data, and member support internally was draining our resources. AnnexMed streamlined our payer operations end to end. Claims processing improved, provider onboarding accelerated, and our administrative burden reduced dramatically. They understand payer complexity like no other partner.

Laura Simmons

Meridian Managed Care

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.

Hospital Solutions

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Payer Services

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Medical Coding Services

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Business Intelligence

Facility AR Follow-Up