Headline result
90+ day AR down 62%
As reported by the client after the engagement. Further figures are published only when both before and after values are on file.
What we did
- 01
Access and setup
We signed a business associate agreement and an NDA, then received user accounts with MFA for the agency's scheduling and EVV system, the clearinghouse, payer portals and QuickBooks Online. Bank feeds were read-only. Our HIPAA-trained staff worked on managed devices with no local downloads, and access logs were kept for every login. The agency owner kept sole authority over payments and write-offs.
- 02
Aging clean-up
We pulled the full AR aging and worked it oldest first. Every claim over 90 days was traced to a status: paid but unposted, denied and fixable, denied and outside timely filing, or never received by the payer. Fixable denials were corrected and resubmitted. Unposted remittances were applied so the aging stopped showing cash that had already arrived. Balances that could not be recovered were listed for the owner's write-off decision, not written off by us.
- 03
Weekly cadence
Visits confirmed in EVV were billed on a fixed weekly schedule so nothing waited for month-end. Each week the team lead reviewed the aging by payer and by bucket, and every claim over 30 days had a next action and a date. Private-pay families received our DunningDesk cadence: statement, reminder, call, and a payment-plan offer where the owner approved it. The month closed under our Two-Tier Review.
- 04
AR follow-up calls under the agency's brand
Our BillingLine desk called payers on unpaid claims and called families on open invoices, using the agency's name and scripts the owner approved. Every call, reference number and promise-to-pay was logged. Agents never took card details; families paid through the agency's own portal. Calls followed TCPA and state rules on timing and recording, and the tone stayed first-party and courteous.
- 05
Reporting
The owner received a weekly cash and aging snapshot and a monthly pack through our LedgerDesk portal: collections by payer, denial reasons ranked by dollar value, days sales outstanding and the 90+ day balance against its starting point. Denial reasons that pointed back to intake, such as missing authorizations, were passed to the agency's scheduling team so the cause was fixed rather than the symptom.