A premier, nonprofit integrated health system partnered with AGS Health to stabilize a highly volatile 90+ day accounts receivable (A/R) portfolio and improve declining recovery performance. Traditional activity-driven workflows limited the organization’s ability to prioritize accounts by financial impact, resulting in reduced recovery efficiency and missed optimization opportunities. The organization engaged AGS Health under an outcome-focused partnership with a contingency-based pricing model to strengthen revenue growth and recovery.
Challenges
- Significant A/R baseline: An initial placement of $17.6M created a high-volume baseline that outpaced existing recovery capacity.
- Inventory volatility: Unpredictable monthly inflows hampered workforce planning, making it difficult to set accurate staffing levels or realistic recovery targets.
- Manual inefficiencies: A heavy reliance on manual follow-up processes extended turnaround times and increased the cost-to-collect without a corresponding improvement in recovery outcomes.
- Suboptimal prioritization: Inefficient routing logic resulted in improper account sequencing, delaying the resolution of high-value claims.
- Complex denial landscape: High volumes of authorization denials, coordination of benefits issues, and payer-specific denial patterns increased rework and delayed resolution timelines
Outcomes
- $12M in recovered revenue in PB collections over 12 months from inherited 90+ day aged A/R inventory
- Achieved an average 16% gross collection rate across aged inventory,exceeding 6% target
- 11x ROI on PB collections per FTE through outcome-based resource alignment
- $14M A/R backlog reduced over 12 months
- Reduced claim denials related to authorizations, coordination of benefits (COB), non-covered services, and escalation-related claims from $6M to $450K in four months
- Approximately 150K accounts resolved across high-impact inherited inventory.
