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by Plutus Health

Case studies
October 26, 2022

Discover How This Medical Lab Collected $1282 Per Claim

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

The Client

An out-of-network specialty lab based in Phoenix, Arizona

The Challenges

• Payment and claims posting delays

• Coding errors and inaccuracies

• Unprocessed denials and rejections

The Plutus Plan

After completing the free revenue health analysis for the lab, Plutus Health reviewed and corrected the overall revenue cycle strategy. The highest priorities during implementation were creating and applying coding standards and modifiers and performing eligibility checks. These two changes alone boosted clean claims percentages. In addition to optimizing the eligibility and coding process, we also focused on creating a solid course of action to manage the appeals and collect direct-to-patient payments as well. 

The Results

• Collection per claim increase from $808 to $1282 

• Increase of 58% in collections per claim

• Decrease of $1.1M in overall AR

Interested in creating the same amazing results for your specialty lab, urgent care, emergency room, behavioral health clinic, or physician’s practice?

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