How a Growing Dental Group Stabilized Cash Flow and Achieved 98% Clean Claims Across 15 Locations

A rapidly expanding dental group operating across three states needed a stronger revenue cycle foundation to support growth. With general, endodontic, and pediatric services spread across 15+ clinics, the organization was facing rising denials, payment delays, and inconsistent documentation.  

To scale successfully, leadership needed a partner who could bring structure, visibility, and financial stability to their operations.

Client Profile

Type: Multi-location Dental Group
Services: General, Endodontic, and Pediatric Dentistry
Locations: 15+ clinics across three states
Scope: Full-cycle RCM, including credentialing, eligibility, coding, claims, A/R, denials, and analytics

The Problem

The group was growing, but their revenue cycle processes were not keeping pace. They faced several challenges that directly impacted collections, cash flow, and operational efficiency.

Key Challenges

• Denial and rejection rates as high as 25% in pediatric and endodontic lines
• Payment delays and rising Days Sales Outstanding
• Manual eligibility verification and inconsistent documentation
• Limited financial visibility with no real-time insights
• High insurance A/R and aging claims are slowing cash flow

Issues Detected

• Decentralized eligibility and authorization workflows
• No unified dashboard for claims, denials, or A/R
• Staff not aligned with current coding and payer rules
• Documentation templates varied across providers
• No proactive denial analytics or structured appeal workflows

Without a clear, scalable solution, the group risked continued revenue leakage and operational strain, limiting their ability to expand and support patient demand.

The Guide

Plutus Health partnered with the dental group as their RCM guide, bringing deep expertise in eligibility, coding, claims management, and denial prevention. By identifying root causes across the workflow and strengthening compliance, Plutus Health implemented real-time authorization workflows, standardized documentation, and structured audits to improve accuracy, reduce denials, and increase revenue integrity across every practice line.

The Plan

To stabilize the dental group’s financial operations and prepare them for scalable growth, Plutus Health deployed a comprehensive RCM transformation spanning eligibility, coding, claims, denials, and A/R.

Eligibility & Authorization

• Automated eligibility and benefits verification across all locations
• Centralized real-time dashboard for authorization and eligibility status
• Training on payer-specific pre-authorization requirements

Coding & Documentation

• Standardized provider documentation templates across specialties
• Routine audits and structured feedback loops for clinicians

Claims & Denial Management

• Payer-specific billing workflows with clear communication paths
• Automated claim scrubbing and clean submission
• Proactive denial analytics and targeted appeal strategies

A/R & Financial Insights

• Automated follow-up to reduce aging claims and improve collections
• Real-time analytics dashboards for leadership
• Monthly KPI reviews with corrective recommendations