How to Handle Your Legacy A/R for System Conversions

A checklist to avoid shortfalls with your legacy A/R before you start your system conversion

System conversions are complex, but we’re here to say it’s possible to have a successful conversion without compromising your cash flow. Gain clarity and insight into planning for your legacy A/R by using this pre-conversion checklist to mitigate your revenue loss.

Pre-Conversion (15-18 months prior to go-live)

Determine the revenue cycle resources you can assign to the system conversion project without causing performance issues with billing, insurance follow-up, and cash flow.
Do you have a plan to backfill or cover those roles?
If you are consolidating operations by restructuring to a centralized business office, can you repurpose staff to create a legacy A/R operation?
What is your retention plan if you create an interim legacy operation? And do you have a backup plan for unexpected resignations?
Have you communicated the risks of cash flow to your leadership team?
Have you determined a run-out period for your legacy system and is that factored into the budget and timeline?
Is a legacy A/R partner the answer?
Will you issue an RFP for a legacy wind down partner or solicit proposals from several vendors?
Do you have a budget approved for a partner?

If you’ve decided to bring in a partner to help manage your legacy wind down, consider starting your bid process around 15 months before you go-live. Here are a handful of questions that might help you start thinking through the process.

Choosing a partner (12-15 months prior to go-live)

Have you identified potential partners that agree to collaborate with you on a wind down strategy, timeline, and plan?
Will they agree to a phased approach, starting 9-12 months prior to go-live for pre-conversion cleanup, cascading the aged A/R, and stay with you post-conversion to run down the final legacy A/R?
Is there a scope of work that includes clearly defined inventory age, financial class exclusions, and an end of project grace period?
Will the A/R follow-up work be performed in your legacy system, or will the partner require you to use their system? Are there pros and cons to either solution?
Should you supply the candidates with an ATB and other claims and payment information to ensure you are getting an accurate quote?
Have you allowed ample time for contracting, legal approval, and technology discussions?
Are the potential partners a good business, culture, and values fit for your organization?
Is there a need for an on-site partner resource?
Have you discussed KPIs (Key Performance Indicators) to be measured and real-time results reporting?
Will the partner offer a choice of contingency or FTE-based pricing and is there an option for performance-based incentives? Are there implementation fees?
Will there be a service level agreement?
Are the proposed rate and overall cost within your budget?
Does the partner have a formal project management process and implementation plan documented?
Have you checked references for the partner?

Partner selection is done. Now what? Be prepared for a 6-8 week process in order to get your partner live and in production. Here are a few things that may help as you prepare.

Implementing the A/R partner services (6-8 weeks)

Does the partner plan to hold a kick-off meeting for introductions, process discussion, and timeline review?
Have they requested your current policies and procedures to support their team training?
Are you prepared to provide access to contractual information or copies of your contracts?
Has the partner outlined the technology access requirements for your billing system, payer systems, and ancillary or supporting systems needed to manage A/R follow up? Is your IT team engaged and prepared to give access based on the timeline?
Will the partner need file transfers and if so, have they established a protocol?
Have you factored in training needs for the new system, developed a timeline, and considered the impact it may have on available staff for an A/R Legacy transition?
Have you identified reporting requirements?

Assessing the success and value of your partner should be an ongoing process during the legacy wind down project.

Legacy wind down evaluation

Did your partner achieve the KPIs and perform the liquidation in a satisfactory manner?
Was your expectation for patient satisfaction met or exceeded?
Did your partner provide value, and should you consider keeping them on beyond the conversion so that you maintain a long-standing healthy A/R and patient experience?

The key to a smooth, successful legacy A/R wind down is choosing the right partner. The patient experience and bottom line results will tell the tale.