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October 26, 2022

Generating Revenue from 270+ AR for an ASC

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

The Client:

The client is a multi-facility Urology ASC with significant AR in 270+ bucket. Due to Covid-19, their collections team faced challenges addressing the AR on time.

The Challenge: Old AR, Purged and Missed Claims

  • 95% of the contracted inventory was over a year old
  • 45% of the AR claims were already purged by the insurance carrier
  • Medical records for most of the claims requested by the insurance carrier were never sent
  • Adjustments posted were incorrect, which impacted the ASC's total AR


Process: ASC Experienced Coding and Billing Team with Denial Experts Fixed the Issues

  • We strategically appealed various denial categories based on payer policies
  • We segregated claims between purged “In Network” and “Out of Network”
  • We rigorously followed up on claims based on Timely Filing and Appeal Limits


Results: Generated $500k+ Revenue from Dead AR

  • We generated revenue of $500k and cleaned AR inventory within 3 months
  • We collected $150k from dead AR Inventory within 30days

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