Large-Sized Behavioral Health & Substance Use Disorder (SUD) Practice Collected $140K from Old AR within 3 Months

The Client

The client is a large Behavioral Health and Substance Use Disorder (SUD) practice in the US. They were struggling with RCM inefficiencies, rising AR, and cash flow issues before partnering with Plutus Health to resolve these challenges.

Challenges Faced

• High appointment cancellations
• No dedicated patient access team
• AR buckets were rising
• Very large and growing 90+ AR
• Sluggish cashflow

Plutus Health’s Plan of Action

We assessed the current state of their RCM and measured their current Key Performance Indicators (KPIs), which helped to illuminate the problems in the client's RCM processes.

Our experts measured current KPIs against our "Best Practices KPIs" to know the gap in performance of each KPI related to RCM.

Our AR specialist detected the root causes of the out-of-control AR and provided a solution to minimize it.

We worked on all the issues to deliver positive results.

Issues Detected

• Lack of RCM Leadership expertise and Staffing/FTE allocations were not in line with the workload required by each key RCM team (EV, Auth s, ERA posting, Patient Payment Posting, Billing, Collections, and AR).
• Front desk was overloaded with too many tasks. They were unable to collect and confirm data, including outstanding high patient balances, before offering services to the patients.
• Client did not have a staff member or process in place to track and manage correspondence received from insurance companies.
• There were appointment scheduling problems and patient demographic errors.
• Client faced long delays in posting both insurance and patient payments.
• There was a long charge lag which led to revenue loss.
• Client had missing encounters that affected their overall RCM process.

To see the results download our case study