As of November 2026, TSI's legacy AR service works the insurance claims and patient balances left in a hospital's old billing system during an EHR conversion, merger or acquisition. TSI works inside the legacy system or from its files, ranks accounts by dollars and filing deadline, and resolves each to cash or close until the old inventory is gone.
Results vary by payer mix and client program.
- Open legacy AR$18.4M
- Claims within 60 days of filing limit1,312
- Worked this week4,870
- Resolved to cash or close61%
- Medicare21 days
- Commercial34 days
- Medicaid47 days
Got a letter or call from TSI about your own account? Go to the Consumer Support Hub or make a payment.
What a conversion does to old AR
Go-live gets the staff, the overtime and the executive attention. The old system gets whoever is left.
That's when legacy AR leaks. Claims stop getting status checks, denials sit unworked, and payer filing limits keep running: 1 calendar year from the date of service for Medicare (42 CFR 424.44) and 12 months for Medicaid claims (42 CFR 447.45), and whatever each commercial contract sets. Meanwhile the license on the old system has an end date, and the people who knew its quirks are training on the new one.
The result shows up a few months later as a cash dip and a write-off nobody planned for. An acquisition does the same thing, with a second team's habits and a third system's data on top.
What's included
Inventory and triage
TSI takes the full legacy AR file, sorts it by payer, age, balance and days left to file, and puts the claims closest to a filing limit first.
Insurance follow-up
Claim status checks, payer calls, portal work, rebills and corrected claims on open legacy claims, with automated status checks on high-volume, low-balance inventory.
Denials and appeals
Legacy denials worked by class and deadline, with appeals filed before the payer's window closes.
Patient balances
Self-pay balances in the old system worked in your name, with coverage checks and financial assistance screening first.
Data mapping and reconciliation
TSI maps the legacy fields, tests postings and withdrawals, and reconciles its inventory with your systems every day.
Close-out
Accounts with no remaining path close with a reason code. Anything still open at the end of the term comes back to you cleanly, account by account.
How it runs
Plan the run-out
Agree on the cut-off date, which inventory TSI takes, the legacy system's end-of-access date and the reporting you need. TSI assigns a project manager and keeps a shared risk and issue log.
Connect to both systems
TSI works inside the old system with credentials you issue, or takes daily files from it. Formats can be HL7, 837/835, flat files or XML, through middleware like Cloverleaf, Rhapsody or Mirth if needed. TSI does the mapping and testing.
Train on your rules
Staff learn your payer contracts, adjustment rules and scripts on top of about 80 hours of new-hire training covering HIPAA, the FDCPA, the TCPA and Regulation F.
Work down by deadline
Specialists work the queue in deadline order and log every action on the account. Staffing scales up for the conversion and back down as the inventory shrinks.
Close the books
Weekly calls track cash, closures and the accounts at risk. At the end, every account is paid, closed with a reason, or returned to you.
Where it fits with the other stages
Legacy AR work can run next to an extended business office program on the new system, so the same team can cover both sides of the cut-over. Denials in the legacy inventory follow the denial management workflow.
Self-pay accounts in the old system get a coverage discovery check before any patient contact. Accident, workers' compensation and VA claims go to complex claims specialists. Balances you decide to write off can go to bad debt recovery in TSI's name as a licensed agency.
What you see
Weekly and monthly reports show legacy AR by age and payer, cash collected, accounts resolved and closed, claims within 30, 60 and 90 days of a filing limit, and daily reconciliation results. A run-out view tracks how fast the old inventory is shrinking against the date your access to the old system ends.
Ask for cash and closures by aging bucket at placement. It shows whether the work is reaching the oldest claims or only the easy ones.
General information, current as of November 2026. It isn't legal advice. Rules change and differ by state, so check the sources linked here and talk to your own counsel before you act on it.
The company behind the work
Questions buyers ask
What is legacy AR cleanup?
Legacy AR cleanup is working the unpaid claims and patient balances left in a provider's old billing system after a conversion or acquisition, until each one is paid, closed or returned.
Who works legacy accounts receivable during an Epic conversion?
Your in-house team, a vendor, or a mix. One way to split it: keep your own staff on the new Epic build and hand the old system's inventory to a vendor like TSI, which works inside the legacy system or from its files until the run-out ends.
How do you wind down old AR after a hospital system conversion?
Start before go-live, since mapping, credentials and training take weeks. Then rank the legacy inventory by dollars and days left to file, work it in that order, reconcile it daily against the old system and close or return whatever is left before your access ends.
Which systems can TSI work in?
Epic, Cerner, Meditech, Soarian, Athena, eClinicalWorks, Allscripts, IDX and custom legacy systems, either inside the system with credentials or through file exchange.
What happens to our data when the project ends?
Open accounts come back to you, account by account, through the same file exchange. TSI keeps records only as your contract and the law require.
How is legacy AR work priced?
TSI quotes each run-out after sizing the inventory. Contingency pricing, where TSI earns a fee only on what it recovers, is one option.
Size the cash at risk in your old system
Pick one payer and one denial class from your legacy inventory. The Denials Economics Sprint shows what working it returns per claim, so you know what a full run-out is worth before you sign for it.
Got a letter or call from TSI about your own account? Go to the Consumer Support Hub or make a payment.
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