From 90+ AR Days to 25: How Automation Transformed Revenue Flow for a Large Behavioral Health Company

Client Overview

A large network of hospitals spread across 36 states providing behavioral health and substance use disorder treatment services reduced 90+ AR days to less than 28 days using Automation.

Facility Profile

• Location: Illinois
• Organization size: Large size
• Specialty: Behavioral health and substance use disorder treatment

Challenges Faced

• 90+ AR balances leading to huge revenue loss
• High claim denials
• Reduction in financial flow
• Delay in claim processing
• Aging claims

Plutus Health's Plan of Action

Plutus Health's team started this project to automate the current RCM processes. Our RPA experts thoroughly analyzed the current process and detected the issues that needed immediate attention.

Issues Detected

• Significant manual process involved generating AR reports from various medical billing systems and converting raw data into cleanly formatted data for further analysis.
• Time-consuming to log into various portals to check the claim status and maintain manual updates in various Excel sheets.
• Significant delays in handling denials as the agent has to manually look into the denial codes, collate all the missing documents from various sources, and upload/fax them to the payor.
• Agent Dependent on processing claims
• Ageing claims growing due to high volumes

To see the results download our case study