Cleared $8M Backlog and Cuts 90+ AR Below 5% in Just 90 Days for a Behavioral Health Company

Client Overview

The client is a large-sized behavioral health and substance use disorder (SUD) service-providing organization spread across multiple locations in the US

The Problem

• The client faced challenges with its 90+ AR. These ARs reached 23% and were rising continuously.
• The client had a massive backlog of about $8M in payment posting.

Plutus Health Plan of Action

We started working for this organization in March 2022 for two of their locations. To begin with, we conducted an AR audit and analyzed the RCM strategy so that the client could understand their workflow. In this process, we identified the following issues:

• Absence of proper patient eligibility verification process.
• Gaps in the patient's medical records.
• Tons of non-posted payments.

Our team implemented a robust process to ensure eligibility and benefits checks 3 to 5 days before appointments. We optimized the eligibility process and reduced patients' medical record gaps.

We did RCA (Root Cause Analysis) and bifurcated payments: payer-wise, $ value wise, & other priority categories and started the posting activity.

We consolidated all the backlog payments to understand the non-posted payment pattern.

We worked on the denials by implementing a proper denial management process.

To see the results download our case study