by and today. joining everyone, us We're for obviously year-end disappointed Thank you, Brett. Hello, results. thanks
XXXX position to within a elaboration a compelling get guidance with our well current more XX,XXX of managed our finished time.
We increase is managed strength underlying volume metric an year, the lot of between a business of managed for procedures. volume case business. XX,XXX, at and case However, of for the over our expectations on in XX% last clarity the and XX,XXX This represents needed
During our surgeries. services. XX,XXX over XXXX, continues demand for strong we provided to oversight be to There
neuromonitoring of is surgeons surgeries is in invasive and the agree risk. standard a Interoperative a for that the nervous system care It vital it at room. essential is operating resource place
our that Importantly, remains are highly unit only reimbursement economics have industry the general. significant business interoperative challenges care scalable not what but industry, compelling plaguing with neuromonitoring larger been health in the despite
the counterbalance leveraging MSA cash and landscape commercial challenging function actions are shared and RCM We are continuing of cost to revenue greatly internal delivery model, by utilizing a our accelerating our to we And necessary our further, payers, reimbursement taking services. exiting our patients. reduce facilities the tele-neurology by from collections
accounts implement new receivable On decision the and made XXXX. prudent strategy the revenue to a during we accrual reserve side,
Our reserves which $XX million higher recorded new factors gross process. aging number debt writes This claims A ending this XXXX, the net million estimation XXXX.
A of reserve. impacted revenue.
We led for $XX.X much in bad of of in revenue of resulted million. accounting revenues year the down to receivable $XX.X XX, a receivable practice reserve December charge approximately and led accounts net accounts earlier our to negatively in
receivable rate not our decrease During more experienced rate only but accounts in which in XXXX, beginning increased XX% reserve. a October, impacted we also negatively Texas arbitration than the accrual state our
during negligible, these our the XXXX, claims Additionally, also debt collections COVID on increasing expense. bad period were
increased in pragmatic XXXX certain given receivable compared $XX taking associated experience to collect $XX million in All challenges reserves, the accounts XXXX to cash approach and we've was reducing and a compared collecting the profitability margins. approach, for in accelerated We're XXXX least headwinds. risk visibility top XXX in line the collecting say company significant XXXX. results. with while, reimbursement uncollectible challenging and forward.
The reduced a industry receipts to environment to future our continued the Using our case our our serves our per XXX revenue, to million accounts XXXX and to substantially impacted receivables days to and our this write-downs negative in going of persistent for It financial factor
to federal was long. into and went of protect the from No the health passed care providers provide time paid. of For service resolution not with extremely was with performed, January rate fair ability federal legislation, to but a continues be the reimbursements, in was claims, XXXX, which submission to to effect best The Surprises intentions: arbitrate where consumers
challenges, than this have filed nearly we which part of ramping other been faced lengthy has claims, claims implementation of times as anticipated, federal operational health number higher under have to resolve governments numerous has led federal including the of an a However, the care legislation legislation. this failure is outstanding to the significantly entire the agencies on the across industry.
To date, and claims XXX
had we first case month, last Just adjudicated. our
it's While results positive, the cases the federal anecdotal we process until more bottleneck. through were
the While our by longer is took resolution XX case. first the in from the what submission legislation, for prescribed time it X days consistently to months was
by are first encouraged We this win.
expect flow. We in in number profitability manner future have on timely of cash an to and arbitration an XXXX. claims resolution federal a The of impact increasing file cases will these
reimbursement and rates reimbursements, October in filing over of is secure in benchmark insurance commercial pressure inbound to industry. that a significant entire been believe into lobbying our have gamesmanship reduced states that on of rates are state there in reimbursement effect cloud claims. provider went accrual rates.
The downward causing certain We the companies the surrounds there reimbursement issues For technical challenging reduction the surrounding a was a number
framework supports turmoil forced to analyze internal surrounding which of competitor its to competitors that much federal competitors private or current was Just been do. rely further business decision This recently, a to and to environment Reimbursement or than the management our companies be they because critical tools data a that primarily our billing like are state we to to the third-party continue reimbursements, for cycle the stores. one business.
Smaller don't have arbitrate on show vulnerable our develop was revenue equity-backed had resources, Assure. in longer
We have understanding remains and cases insurance success us essential this to developed revenue ultimately arbitration reimbursement will expand in flow is you to a be the key which case managing the M&A believe pursue for our data and and a expect in per contractual data-driven arbitration to and cycle improve need differentiator industry our analytics term, business.
Consistent successful. win and cash turn agreements will to up XXXX. consolidation analytical a case. in was lead believe managed selectively process will speed approach We We commercial to strengthening and in-network we volume payers, the ranks. our and participation There near in with in help opportunities that case more
United extended in top being looking already include the the our significant as X reach in New high-performing this among we a to XXXX, business geographical footprint. State market we Jersey, reimbursement of and profile has markets are Texas like the XXXX, a add have well which as to historically expand strong States. had we Colorado, new in where
The that and salaries million we this reduction in cost in operating elements plan reduction the staff in costs. initiated in of plan for reduction reduction On incremental side, a a $X this include targets current an a year, further February annualized cost headcount.
the an This will as XXXX. results introduced salary beginning in costs to plant impact more We $X reductions than quarter expect million our workforce that in the is evident plan second financial become and earlier as in other in fiscal the this of XXXX. more addition well was of
have and data challenges, improve the number cash industry cutting manage are a the professionals, achieve the operations from interoperative we and and space and us management hurdles use industry our robust neuromonitoring processes help half a these serve on withstand capital the XXXX. all cycle overcome of analytics, and We is around cost to facing back XXXX. equipment we well sustained While that to profitability and we of challenges of will during the are analytics infrastructure revenue optimistic the in flow second end of positioned process.
Through reimbursement
is the is for there. to operation. surgeries We is room. risk our place resource demand a interoperative at operating nervous self-sustaining invasive still that the neuromonitoring and a vital essential are business in system The rightsizing Again, be
point out steadily increased our period the XX- cash into trailing and has X-, reserve, around the collected the XX-month to total notwithstanding want I issues basis. that
$XX.X We to which XXXX. continue MSA collections, XXXX XXXX to experience to compared cash in strong anticipate XXXX. we including collections, in-network in million cash agreements, collections compared in and to million $XX benefit achieve XXXX.
We collected million from $XX.X million in would further during $XX.X Total were
exit that no majority we of partners. by supporting second and exited Additionally, expect managed XXXX. revenue of we to business agreements these with require longer quarter service fully the have surgeon are agreements And the our shares
of as shared MSAs. flow collecting and an receipts achieving a that controlling all more we cash of incremental under month $XXX,XXX As result cash currently per was of anticipate result, additional or a that
Importantly, we cash are rates, participation shortening cycle and achieving driving better higher our collections.
pass have to data-driven internal cycle market. a We're off revenue to into quarter better in improve function first collections management XXXX, forecast has Days and higher headed are and at commercial been year. be payment measurable to a have believe rate increasing. percentage than with that encouraging built continuing the of an last is pay improve We revenue payers versus rates improvement.
The reduced will sophisticated our collections paying visibility been toward our and first start what we
rebounding year, receiving from appear we towards to And the While still reimbursement fair possibly XXXX. in provide. we are for early a closer and be rate stabilizing the services moving rates
and our of are and cost we favorable markets adding costs reducing with revenue fixing, scale our services. on case, management aligning controlling and in ahead, expectations the Looking delivering focused updated
walk Next, will full John financials. the Price John? us year through
