The Challenge
An internal medicine practice in Michigan came to AMS Solutions carrying an accounts receivable problem that had quietly compounded. Total AR sat above $600,000, with roughly $140,000 stuck in the 120-day-plus aging bucket — the oldest, hardest-to-collect money in any revenue cycle.
Underneath the AR number was a backlog of unfinished work: 3,894 claims pending with insurance, 990 claims with no payer response, and more than 600 unworked rejections. Denials went unworked. Claims were submitted twice. Rejections sat unresolved. Payment posting was inconsistent, and there were no payer-specific billing guidelines to keep submissions clean. The result was an unsustainable backlog and unpredictable cash flow.
The Solution
AMS began with a full AR review, then rebuilt the practice’s workflows around three disciplines: denial management, real-time rejection resolution, and tighter work-queue oversight.
We introduced payer-specific billing guidelines and aligned CPT and diagnosis coding to each payer’s actual behavior — cutting avoidable denials at the point of submission rather than chasing them afterward. Payment posting was moved from 46% manual to 100% electronic, eliminating the errors that had been distorting patient-responsibility balances. And where revenue had been incorrectly shifted to patients, AMS recovered it by rebilling denied claims and correcting workflows across every payer category.
The Results
As of May 2026, total AR has been reduced by almost $300,000. The 120-day-plus bucket — the practice’s worst aging — is down to just 6%, and 70% of all AR is now current. Denials and rejections are worked the same day they’re received, so the backlog never rebuilds. Payment posting is 100% electronic, and patient-responsibility balances have been corrected across all accounts.
This partnership demonstrates the impact of consistent execution, proactive claim management, and payer-specific optimization — giving the practice a more stable, scalable revenue cycle and a strong foundation for future growth.
— AMS Solutions, Revenue Cycle Management
Explore more AMS case studies, or learn about our full revenue cycle management services, denial management, and internal medicine billing.
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