RCM Case Study: Accelerating Cash Flow Through Strategic Accounts Receivable Management

A growing physician-owned medical group in the USA partnered with Dilijent Systems to regain control over its accounts receivable problems. The practice included 4 different specialities and processed nearly 3200 patients each month.

Despite the large number of patients each month, the medical organization faced a lot of revenue problems, as much of the finances were stuck within the unpaid and aging claims, causing financial illiteracy.

Here are some of the challenges the healthcare organization faced and how Dilijent Systems solved all these problems:

The Challenge

Before working with us, the practice faced serious A/R-related issues:

1. Excessive Aging A/R

More than 45% of outstanding claims were over 90 days old, making recovery difficult.

2. Poor Claim Follow-Up

Claims were not followed consistently, leading to payer delays and silent denials.

3. Payer Communication Gaps

Lack of structured payer escalation resulted in repeated resubmissions without resolution.

4. Write-Offs & Lost Revenue

Old claims were being written off without proper investigation.

5. Staff Burnout

The internal billing team was overwhelmed and unable to manage high A/R volume effectively.

How Dilijent Systems Solved the Problem

Here’s how Dilijent Systems handled all the problems in the healthcare facility:

1. Deep A/R Audit

Dilijent System did a deep account receivable audit that helped us analyze all the shortcomings and revenue losses. We analyzed all the claims that were older than 30,60, and 90 days. Each claim was analyzed to identify payer-related issues, denial reasons, and the current claim status so no problem was overlooked.

2. Dedicated A/R Task Force

A dedicated team of A/R team was assigned based on payer type. Every open claim was given clear ownership, ensuring accountability and consistent follow-up until payment was received. 

3. Structured Follow-Up System

We started a strict 14-day follow-up cycle for unpaid claims. This way, the different rules were applied for different insurance companies, and each claim was handled individually. 

4. Denial & Underpayment Recovery

Previously ignored claims were carefully reviewed and appealed. We also identified underpaid claims and recovered lost revenue.

5. Payer Intelligence Mapping

The researchers detected slow-paying insurance companies that presented a high-risk assessment through their research. The researchers used payer behavior information to create new strategies that improved their response times and payment accuracy.

6. Transparent Reporting

The team used weekly A/R aging reports to monitor their progress. The monthly reports showed recovered revenue and cash flow performance, together with information about collectible and non-collectible claims.

Results Achieved (Within 90 Days)

1. A/R Over 90 Days Reduced by 52%

The team actively recovered stale claims instead of choosing to write them off.

2. Net Collections Increased by 31%

The organization achieved substantial cash flow gains without needing to increase its patient services.

3. Average Payment Time Reduced by 40%

The organization achieved faster payer responses through its ongoing follow-up activities.

4. Recovery of Previously Written-Off Revenue

The organization recovered thousands from unclaimed reimbursements.

5. Billing Team Productivity Improved by 35%

The implementation of defined processes helped employees to manage their work tasks more effectively.

6. Predictable Monthly Cash Flow Restored

The leadership team developed greater trust in their ability to forecast financial outcomes.

Client Testimonial

“Our biggest issue was money lost due to A/R. There was no clear answer as to where the money was going. Dilijent Systems took control of our A/R cycle and recovered all the revenue lost because of aging and unpaid claims. We finally got control of our cycle again.”

Practice Manager, Multi-Specialty Medical Group