From Crisis Recovery to Strategic Partner: How Pharmbills Collected $10M in Aged AR in Under 60 Days
By the numbers
$10M in aged receivables recovered in less than 2 months against a $40M+ backlog
Collections team fully assembled in 1 week, trained on state-specific payer logic
Existing AR/billing partnership expanded into high-stakes collections work after 6 months of trust
Multi-payer coverage across private, commercial, Medicare, and Medicaid, including aging dating back to 2022
Multi-state payer coverage with state-specific specialization built from zero
Background Story
In outstaffing, trust is not marketed. It is earned in one engagement and cashed in on the next.
Pharmbills had been supporting a back-office RCM company, serving multi-state Skilled Nursing and Assisted Living portfolios, for roughly six months. The scope was AR and billing, the standard engagement. Steady, executed well, but not glamorous. Then the conversation changed.
The client was sitting on more than $40M in uncollected receivables managed on behalf of its own clients. The aging stretched back to 2022 and spanned every major payer category: private pay, commercial, Medicare, and Medicaid. Internally, they did not have the bandwidth to hire, train, and supervise a collections team at that scale, and they did not have the runway to build one from scratch. Every additional day of aging increased write-off risk and put their own performance commitments to the underlying facilities in jeopardy.
They did not open a vendor search. They came back to Pharmbills. The AR/billing engagement had done its job: it proved we could execute. The collections ask was the client betting on that track record with meaningfully higher stakes.
Pharmbills had been supporting a back-office RCM company, serving multi-state Skilled Nursing and Assisted Living portfolios, for roughly six months. The scope was AR and billing, the standard engagement. Steady, executed well, but not glamorous. Then the conversation changed.
The client was sitting on more than $40M in uncollected receivables managed on behalf of its own clients. The aging stretched back to 2022 and spanned every major payer category: private pay, commercial, Medicare, and Medicaid. Internally, they did not have the bandwidth to hire, train, and supervise a collections team at that scale, and they did not have the runway to build one from scratch. Every additional day of aging increased write-off risk and put their own performance commitments to the underlying facilities in jeopardy.
They did not open a vendor search. They came back to Pharmbills. The AR/billing engagement had done its job: it proved we could execute. The collections ask was the client betting on that track record with meaningfully higher stakes.
How We Approached the Challenge
01
Reading the Urgency Correctly
The request was not for a staffing plan. It was for recovered cash. We treated it as a revenue recovery engagement with a staffing component, not the other way around. That framing changed every downstream decision: team size, payer mix, sequencing of accounts, and how we measured success.
02
Assembling the Team in One Week
Standing up a collections team in seven days is not a recruiting exercise. It is a bench-readiness exercise. We drew from specialists already fluent in the state payer landscapes the client operated in, matched them to the aging mix, and activated them against live accounts within days of sign-off. No ramp period. No extended shadowing. The first dollars were moving while most outsourcing providers would still be scheduling interviews.
03
Specializing by Payer, Not by Account Volume
Private, commercial, Medicare, and Medicaid follow different playbooks. The appeal windows, documentation standards, and escalation paths are not interchangeable. We segmented the backlog by payer type and assigned specialists with direct experience in each, including the state-specific Medicaid rules that determine whether a 2022 claim is still recoverable or permanently lost. This is where generalist teams lose the money. Specialists find it.
04
Prioritizing by Recovery Probability, Not Age
The obvious instinct with old aging is to chase the biggest balances first. The disciplined instinct is to chase the balances most likely to convert inside the window. We scored the backlog on payer type, claim status, and timely filing exposure, then worked the highest-probability accounts first. That is how $10M came off the books in under 60 days instead of being spread thin across a $40M chase.
05
Transparent Reporting, Client-Controlled Pace
We gave the client full visibility into queue status, recovery velocity, and account-level disposition from day one. No black box. The client could see what was collectible, what required their input, and what was being written off with justification. That transparency is what kept a high-stakes project on rails under real-time pressure.
The Outcome: Cash Recovered, Trust Reinforced
The strongest signal of success was not the $10M recovered. It was the fact that this project existed at all.
A client handing over $40M in aged receivables is not a procurement decision. It is a trust decision. Six months of steady AR and billing execution is what earned that call. The collections project was awarded because the groundwork was already paid for.
$10M is on the board. $30M is still in motion. The project continues until the full backlog is worked, and the bar has been set by what the team delivered in the first 60 days.
Execution got us the staffing contract. Trust got us the crisis.
A client handing over $40M in aged receivables is not a procurement decision. It is a trust decision. Six months of steady AR and billing execution is what earned that call. The collections project was awarded because the groundwork was already paid for.
$10M is on the board. $30M is still in motion. The project continues until the full backlog is worked, and the bar has been set by what the team delivered in the first 60 days.
Execution got us the staffing contract. Trust got us the crisis.
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Brandon Bolnick
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