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