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Midwest Service Bureau

Case Studies

How MSB approaches collection engagements across healthcare, utilities, dental practices and government agencies.

  • No recovery, no fee
  • Licensed where required
  • HIPAA compliant

At Midwest Service Bureau, we measure our success by the results we deliver for our clients. The following case studies illustrate how our industry-specialized teams and compliance-first approach work on aging and difficult-to-collect accounts. These represent a cross-section of the industries we serve — from healthcare and municipal utilities to dental practices and government agencies — demonstrating the versatility and effectiveness of MSB's approach across different account types, balance ranges, and regulatory environments.

These case studies are illustrative composites; details are changed to protect confidentiality, and they are not individual client results, so no outcome figures are shown. Each follows the same structure: the challenge the organization faced and the approach MSB took.

By the numbers

The Firm Behind These Engagements

The case studies below represent a cross-section of our work. The approach they share — early placement, skip-tracing, compliant multi-channel contact and relationship-preserving communication — is the same one we apply to every client.

1970
Founded in Wichita, Kansas
A+
BBB Rating, Accredited Since 2016
No Fee
Unless We Recover (Contingency)
Nationwide
Collections Coverage

Each engagement begins with a thorough understanding of the client's unique challenges, followed by a customized strategy that draws on industry-specialized collectors and multi-channel outreach. We measure success not just by dollars recovered, but by compliance integrity, relationship preservation, and the operational improvements we deliver to our clients' revenue cycles.

What these engagements share is a combination of three strengths: account review that sets the right approach for each account, people who bring expertise and empathy to every interaction, and a compliance program that protects our clients from regulatory exposure. The following case studies illustrate this approach across four different industries.

Healthcare

Regional Hospital System: Aged Self-Pay Balances

The Challenge

A regional hospital system with three facilities and over 400 beds was facing a growing crisis in self-pay collections. With $2.3 million in aged patient self-pay balances — many over 120 days past due — the hospital's internal billing team was overwhelmed. Staff turnover in the billing department had reached 40% annually, and remaining team members were splitting their time between current billing, insurance follow-up, and collection calls on aging accounts. Recovery rates on self-pay balances over 90 days had fallen below 8%, and the hospital's CFO estimated that the organization was writing off over $1.5 million annually in collectible self-pay debt.

Compounding the challenge, the hospital needed a collection partner that could maintain strict HIPAA compliance, accept placement files from their Epic EHR system, and preserve patient relationships in a community where the hospital was the primary healthcare provider. Previous experiences with collection agencies had resulted in patient complaints and negative community perception, making the selection of a new partner a high-stakes decision.

The Solution

MSB implemented a comprehensive recovery strategy combining our early-out patient collection program with third-party collections for older accounts. The engagement began with a scheduled placement file from the hospital's Epic system and payment files returned for posting. MSB reviewed every account and assigned contact strategies based on balance size, age, and insurance payer history.

For accounts in the early-out phase (30-90 days), MSB's team contacted patients using the hospital's name (first-party branding), explained their financial responsibility, offered flexible payment plans, and screened patients for financial assistance programs including charity care, Medicaid, and the hospital's own sliding-scale program. Financial counselors screened patients for Medicaid and the hospital's charity care program, so eligible balances could be resolved without collection activity.

For older accounts (90+ days), MSB's third-party collectors used multi-channel outreach — phone, mail, email, and text — with empathetic, compliance-focused messaging designed to encourage voluntary payment. MSB's secure online payment portal allowed patients to make payments or set up installment plans at any time. All communications were reviewed by MSB's compliance team to ensure HIPAA, FDCPA, and state regulatory compliance.

Municipal & Utility

Multi-State Utility Provider: Delinquent Utility Accounts

The Challenge

A multi-state utility provider serving communities across the Midwest had accumulated over 45,000 delinquent accounts totaling approximately $4.3 million in unpaid water, electric, and gas bills. The utility's internal collection efforts had been limited to late payment notices and service disconnection threats, with minimal follow-up after accounts were written off. Average account balances ranged from $50 to $2,500, with the majority clustering between $75 and $400 — a range that made individual legal action impractical but represented significant aggregate revenue.

The utility needed a collection partner experienced in municipal and utility collections who could navigate the complex regulatory environment governing public utility debt recovery, including state-specific disconnection rules, customer hardship protections, and public records requirements. The utility board also required detailed reporting for regulatory filings and public accountability.

Adding complexity, the utility's customer base spanned both urban and rural communities across multiple states, each with different consumer protection statutes governing utility debt collection. Some jurisdictions imposed specific timing restrictions on when disconnection-related debts could be pursued by third parties, while others required enhanced disclosures about available hardship assistance programs. The utility's previous attempt to use a generalist collection agency had ended poorly — the agency's form letters failed to include required state-specific disclosures, generating regulatory complaints that the utility's compliance officer had to address personally.

The Solution

MSB deployed its municipal collections team — specialists experienced in government-sector debt recovery and the unique regulatory requirements that apply to public utilities. Our approach began with a comprehensive data analysis of the 45,000-account portfolio, segmenting accounts into priority tiers based on balance, age, customer payment history, and geographic factors.

High-probability accounts received multi-channel outreach combining demand letters, phone contact, and email. MSB's collectors contacted customers within business hours using professional, non-threatening language that emphasized the utility's preference for resolution and offered convenient payment options including online payment, phone payment, and installment plans. Medium-probability accounts received letter campaigns with phone follow-up for responsive contacts. Low-probability accounts were placed on automated letter sequences that need minimal resource investment.

Our state-by-state compliance review identified two jurisdictions with recently enacted customer hardship protections that the utility's previous collection partner had not incorporated into their processes — a gap that could have created regulatory exposure. MSB's reporting was customized to meet the utility's board reporting and regulatory filing formats, with drill-down capabilities by service territory, account age, and balance range.

Dental

Dental Practice Group: Insurance Denials and Patient Balances

The Challenge

A dental practice group operating seven locations across two states was struggling with two interrelated collection challenges: a growing backlog of insurance claim denials and an increasing volume of patient self-pay balances resulting from high-deductible dental plans. The practice group's office managers, already stretched thin managing daily operations, could not dedicate adequate time to appeals processes or patient follow-up. Over $850,000 in combined insurance denials and patient balances had accumulated, with some accounts over 180 days old.

The practice group needed a partner experienced in dental collections who understood dental insurance billing codes, common denial reasons, patient communication in the dental context, and the importance of preserving patient relationships — especially since the practice group relied heavily on referrals and repeat patients for growth. Two previous collection agencies had generated significant patient complaints and damaged the practice's community reputation.

The Solution

MSB assigned its dental collections specialists to the engagement — a team with specific expertise in dental billing, insurance denial management, and patient communication for dental practices. The solution combined two strategies: first, MSB's team reviewed and appealed insurance claim denials that the practice group had not had time to pursue, recovering significant revenue that insurance companies owed but had initially refused to pay. Second, MSB implemented a patient-centered collection approach for self-pay balances, using gentle, empathetic outreach that acknowledged the often-unexpected nature of dental costs.

Patient communications were branded with the practice group's name during the early-out phase, and MSB's collectors were trained on the specific dental procedures and billing scenarios common to the practice's patient population. Payment plans were offered with low monthly minimums, and patients who expressed financial hardship were directed to dental financing options. MSB also provided the practice group with monthly analytics identifying patterns in denials by payer and procedure code, enabling the group to improve its front-end billing processes.

Workers' Compensation

Government Agency: Workers' Compensation Overpayment Recovery Program

The Challenge

A state-level government agency responsible for administering workers' compensation benefits across its jurisdiction had identified over $3.8 million in overpayments made to claimants over a five-year period. These overpayments had accumulated due to a variety of factors: claimants who returned to work but failed to report income changes, benefits paid beyond the approved duration due to administrative processing delays, duplicate payments resulting from system migration errors, and benefit calculations that were later revised downward after medical re-evaluations.

The agency's internal recovery efforts had been largely unsuccessful. With a small finance team already stretched thin managing current claims, the staff could dedicate only a few hours per week to overpayment recovery. Their approach — sending a single demand letter followed by sporadic phone calls — had yielded a recovery rate of just 4% over two years. The agency lacked specialized collection software, skip tracing capabilities, and the legal infrastructure to pursue reluctant overpayment recipients. Additionally, the political sensitivity of collecting from injured workers created internal hesitancy about aggressive recovery efforts, even though the agency had a legal obligation to recover public funds.

The agency needed a collection partner with specific experience in workers' compensation collections — a niche that requires understanding of workers' comp benefit structures, overpayment calculation methodologies, state-specific recovery statutes, and the sensitive human dynamics involved in collecting from individuals who have experienced workplace injuries. The partner also needed to meet strict government procurement and reporting requirements, including detailed audit trails and compliance with state open records laws.

Further complicating the recovery effort, many of the overpayment recipients had changed addresses since their workers' compensation claims were closed. The agency's records contained outdated contact information for approximately 40% of the accounts, making initial outreach impossible without specialized skip tracing capabilities. Some claimants had relocated out of state, raising questions about jurisdictional authority and the applicability of different state statutes governing overpayment recovery. The agency also faced a statute of limitations concern — under state law, the window for administrative recovery of certain overpayment types was approaching expiration, creating urgency to begin a structured recovery program before legal options narrowed further.

Our Approach

MSB deployed a specialized team with extensive experience in government-sector collections and workers' compensation recovery. Our approach was methodical, compliant, and designed to balance effective recovery with the sensitivity required when dealing with injured workers.

Phase 1 — Data Analysis & Segmentation (Weeks 1-3): MSB's data team ingested the agency's overpayment records, cleansed the data to remove duplicates and resolve address discrepancies, and reviewed every account. Accounts were segmented into tiers based on overpayment amount, recency of the claimant's last known contact, employment status, and estimated ability to pay. High-value accounts with strong contact information were prioritized for immediate outreach, while accounts with outdated information were routed through skip tracing to locate current contact details.

Phase 2 — Compliant Multi-Channel Outreach (Weeks 4-16): Our collectors initiated contact through state-approved demand letters that clearly explained the overpayment amount, the legal basis for recovery, and the claimant's options for repayment or dispute. Follow-up included phone calls during approved hours, email outreach for claimants with verified email addresses, and referral to the agency's formal appeals process for claimants who disputed the overpayment calculation. Every communication was reviewed against state workers' compensation statutes and the agency's approved messaging guidelines.

Phase 3 — Payment Resolution & Hardship Accommodation (Ongoing): MSB offered flexible repayment options including lump-sum payments, monthly installment plans scaled to the claimant's ability to pay, and offset agreements for claimants still receiving active benefits. For claimants experiencing genuine financial hardship, MSB worked with the agency to explore compromise settlements and statutory hardship waivers where applicable. This compassionate approach reduced resistance and increased voluntary payment rates substantially.

Phase 4 — Escalation & Legal Referral: For non-responsive claimants with significant overpayment balances, MSB prepared detailed case files and recommended legal referral to the state attorney general's office or approved collection attorneys. MSB's documentation met evidentiary standards for administrative hearings and court proceedings, streamlining the legal recovery process for the agency.

What we see

Common Themes Across Our Engagements

While every client's situation is unique, several themes consistently emerge across our engagements:

Compliance Comes First. MSB's FDCPA, Regulation F and HIPAA compliance program, staff training, and compliance review of flagged calls govern every communication, so the revenue MSB recovers does not come at the cost of regulatory risk.

Empathy Increases Recovery. Across healthcare, utility, dental, and workers' compensation engagements, MSB favours an empathetic approach over aggressive collection tactics. When debtors feel respected and understand their options, they are more likely to commit to payment arrangements — and more likely to complete those arrangements over time.

Upstream Insights Create Long-Term Value. In these engagements, MSB looks for operational improvements that went beyond collecting existing accounts. Revenue cycle feedback for the hospital, final billing process improvements for the utility, denial pattern analysis for the dental group, and overpayment prevention recommendations for the government agency — these consulting-level insights create ongoing value that compounds over time, reducing future collection needs and improving overall financial performance.

Your turn

Ready to Write Your Own Success Story?

Every organization's collection challenges are unique, and MSB's solutions are tailored to your specific industry, account mix, and goals. Whether you're a healthcare system dealing with self-pay balances, a utility provider with thousands of delinquent accounts, a dental practice struggling with insurance denials, or a government agency recovering overpayments, MSB brings experience in each of these sectors.

Our free portfolio analysis gives you projections for your specific accounts before you make any commitment. We'll review your account data — balance distributions, aging buckets, payer mix, historical recovery rates, and write-off patterns — and produce a detailed report with projected recovery amounts, recommended strategies, and return-on-investment estimates specific to your organization. There's no obligation and no cost.

MSB has the experience and specialized expertise to work your accounts. Contact us today to get started with your free analysis and take the first step toward recovering the revenue your organization deserves.

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