Billing Stabilization and Recovery for a Skilled Nursing Operator
Client Profile & Engagement
Organization Profile
- Multi-facility SNF operator preparing for portfolio sale
- 6-facility portfolio under evaluation by potential buyers
- Underperforming billing team with process gaps
- Opportunity to demonstrate improved collections pre-sale
Scope of Engagement
- Complete takeover of billing operations
- Staff recruitment, training & oversight
- Claim management & follow-up protocols
- Pre-sale financial stabilization
The Challenge
A six-facility SNF operator preparing for a portfolio sale recognized that his billing team was leaving significant money on the table. With an underperforming team lacking process discipline and proper Medicaid tracking, collections were delayed and revenue was being lost before the critical ownership transition.
Slow Claim Follow-up
Claims waited 30+ days before follow-up, causing payment delays
Missed Revenue
Lack of discipline around denials and authorization errors
Medicaid Pending Backlog
No structured tracking of pending applications
Team Accountability Gap
Existing billing team lacked process rigor and follow-through
Our Implementation Strategy
We executed an immediate operational takeover while building a sustainable, trained team for long-term success.
Phase 1: Immediate Operational Takeover
Department Assessment
Audited current team and identified process gaps
Staff Restructuring
Hired new collectors and trained on best practices
24-Hour Protocol
Implemented accelerated claim follow-up system
Cash Flow Stabilization
Addressed rejections and improved collections
Phase 2: Team Building & Transition
Hiring & Training
Built skilled, motivated collections team
Process Documentation
Created repeatable workflows and playbooks
Back Billing Recovery
Submitted valid past claims systematically
Handoff to Owner
Transferred sustainable operation to operator
What We Delivered
| Deliverable | Immediate Impact | Long-Term Benefit |
|---|---|---|
| Billing Department Takeover | Stabilized cash collections immediately | Built skilled team with sustainable processes |
| 24-Hour Follow-up Protocol | Reduced claim lag from 30+ days to same-day | Institutionalized best practice as standard |
| Back Billing Recovery | Recovered significant past-due amounts | Demonstrated value to prospective buyers |
| Medicaid Pending System | Cleaned up aging application backlog | Weekly tracking prevents future delays |
| Staff Training & Playbooks | New team productive within weeks | Owner can maintain collections performance post-sale |
Key Deliverables
Full Billing Department Takeover
Accelerated Cash Workflow
Service & Back Billing Recovery
Hospital Partnership Strategy
Measurable Results
Faster Cash Turnaround
Improved post-bill follow-up reduced reimbursement delays significantly
Recovered Lost Revenue
Back billing efforts captured substantial sums from unbilled services
Improved Medicaid Conversions
Weekly pending reviews increased conversion rates dramatically
Stabilized Post-Sale Collections
Seller met financial targets despite facility transition