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by Plutus Health

Case studies
September 19, 2023

An OBGYN Provider Generated $245k+ from Old AR and Denied Claims in 3 months

by Plutus Health
Coding Quality of Nephrology Practice Reached 98%Download PDF


Mid-sized OBGYN provider based in Illinois.  

Challenges Faced

  • Claim rejection at the clearinghouse 
  • Claims were stuck in open balance or unsettled account 
  • Their AR buckets were rising  

Plutus Health's Plan of Action

Our team prepared a detailed strategy to streamline clients' RCM processes. 

  • We started with a thorough analysis of their RCM process which uncovered existing gaps.
  • Our team identified the reason behind major denials with our advanced denial and rejection analysis tool.
  • Our denial management specialists identified analyzed the denial pattern. 
  • We worked on all the issues to deliver promising results.

Issues Detected

  • BCBS claims got denied for "Taxonomy codes missing on the claim form"
  • BCBS claims denied stating, "Not enrolled with the payer"
  • Contracts with insurance got terminated
  • Credentialing and non-participating issues led to a significant loss in reimbursement 
  • Payment posting was out of TAT
  • Untimely AR follow up 

Plutus Health Solution

  • We guided the client in enrolling backdated and resubmitted claims.  
  • Professionals from our team helped the client withTAT and posted all the payments.
  • Plutus Health's highly experienced billers fixed the practice management billing system to remove the missing code issues.
  • Our credentialing expert helped the client with backdated credentialing to reduce AR.
  • Denial management specialists from Plutus Health addressed all the denied claims in 48 to 72 hours.


The client achieved uninterrupted cash flow in just three months of working with us.

  • Generated revenue of over $245K from AR & denied claims. 
  • Brought down the AR days to minimum and denial rates below 5%

Download Case Study


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