Client Snapshot
Organization Type
Skilled Nursing Facility (SNF) operator with a portfolio of 6 facilities in the Northeastern U.S., undergoing ownership transition.
Scope of Services
• Billing department takeover and collections
• Billing process redesign and staff training
• Medicaid pending tracking systems
• Back billing recovery
• Private pay enforcement and hospital coordination
The Challenge
The SNF operator was preparing to sell his six-facility portfolio but recognized that the billing team was underperforming and leaving significant money on the table. He engaged Kaizenleap to take over and fix the billing operation before the sale to maximize collections during his ownership period. The engagement also extended post-sale, with Kaizenleap continuing to collect on all receivables tied to his dates of service. The existing team lacked process discipline, proper Medicaid tracking, and follow-through on denials – resulting in delayed and lost revenue. Immediate intervention was required to stabilize cash flow and secure recoveries before and after the transition.
Our Role: Full Takeover of Billing to Accelerate Cash and Cleanup AR
Kaizenleap assumed operational control of the client’s billing department, including rehiring staff, retraining processes, and directly overseeing all payer types. Our focus was to reduce delays, recover missed opportunities, and enforce discipline around collections during a high-risk transition period.
Key Areas of Focus
Billing Process Redesign
• Overhauled the post-billing workflow to ensure all claims were followed up within 24 hours, rather than waiting 30+ days
• Introduced rapid response loops for fixing authorization and submission errors, accelerating cash flow
Service Recovery and Back billing
• Identified billable services previously missed and worked with facility teams to gather supporting documentation
• Submitted claims for past services as far back as payers would allow, unlocking substantial missed revenue
Medicaid Pending Oversight
• Created structured weekly calls with each facility’s BOM to review and track every Medicaid pending case
• Developed custom support strategies for complex applications and missing documents
Private Pay Collections
• Set clear expectations and timelines for families regarding payment terms and enforcement
• Standardized communications and tracking to reduce payment lag
Hospital Collaboration on Unfunded Patients
• Negotiated agreements with local hospitals to pay private rates for Medicaid-pending admissions
• Sent hospitals weekly status reports to ensure transparency and sustained referral relationships
What We Delivered
| Deliverable | Impact |
| Full Billing Department Takeover | Rehired and retrained billing staff to operate under Kaizenleap oversight, improving accountability |
| Billing Process Redesign | Accelerated cash flow by addressing rejections and authorizations within 24 hours of submission |
| Service Recovery | Recovered unbilled revenue by submitting valid past claims with documentation |
| Medicaid Pending System | Established weekly tracking calls with BOMs and built consistent workflows for follow-up |
| Private Pay Discipline | Reduced aging private balances by enforcing structured collection processes |
| Hospital Partnership Strategy | Secured short-term reimbursement from hospitals for unfunded admits, improving financial stability |
Results
• Faster Cash Turnaround: Improved post-bill follow-up led to quicker reimbursements and fewer denials
• Recovered Lost Revenue: Backbilling efforts captured significant sums from services previously unbilled
• Improved Medicaid Conversions: Weekly pending reviews increased conversion rates and reduced delays
• Stabilized Collections Post-Sale: Allowed the seller to meet financial targets despite facility handoffs
• Strengthened Hospital Relations: Kept admissions flowing by ensuring short-term payment arrangements for unfunded residents
Why It Worked
Kaizenleap brought hands-on leadership, real-time accountability, and repeatable systems to a chaotic billing environment. By combining rapid process changes with team integration and external negotiations, we delivered real financial results in a tight post-sale window – preserving cash flow and credibility for the outgoing operator.