Aged ASC AR turnaround: $4.55M worked down to $0.76M in nine months
Client Profile
Specialty: Ambulatory Surgery Center
Location: USA
Size: ASC within a multi-site operator
This case study shows how an ambulatory surgery center reduced its aged AR balance by 83.4% and its open account count by 87.8% in nine months through a disciplined five-step weekly operating cycle, without adding headcount.
The Challenges:
An anesthesia group was receiving out-of-network reimbursements far below billed charges and needed to recover fair, market-aligned payment.
- $4.55M in aged AR spread across 1,065 open accounts at go-live
- 65% of the book (by value) already past 180 days, and 31% past one full year
- 237 accounts (~$1.41M) past 365 days, many at or beyond payer filing and appeal windows
- Repeat resubmission of denied claims causing the same accounts to re-enter the follow-up queue
- Undifferentiated follow-up consuming capacity on aged balances with low collectability
Plutus Health Plan of Action:
Data was collected from the client's aging reports and Plutus's collections ledger to establish a baseline and size the recoverable opportunity. The assessment methods included:
- Reviewing the go-live aging report (1,065 accounts, $4,549,492) against the August 14, 2026 report
- Establishing the baseline aging profile across all age buckets
- Tracking collection velocity weekly against that baseline
Issues Detected:
- Root-cause denial and billing discrepancies (coding, coverage, documentation) driving repeat resubmission rather than resolution
- High-balance, recoverable accounts at risk of aging out of filing limits while sitting in an undifferentiated queue
- Highest-balance tail accounts (avg $5,827) requiring disposition decisions rather than routine follow-up