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A/R Wind Down

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.

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