Plutus Health Boosts Collections by $2.49M and Slashes 90+ Day AR

Client Overview

The client, a healthcare provider with a high volume of insurance and patient claims, struggled with collections and aging accounts receivable(AR). They managed RCM in-house but faced challenges in handling claims over 30 days, denials, and rejections efficiently.

Challenges Faced

The client’s in-house team experienced several obstacles:

• A high volume of claims, with many requiring follow-ups greater than 30 day range.
• An increasing number of aging claims, particularly in the 90+ day category, negatively impacted cash flow.
• Higher-than-average coding denials and rejections indicate potential areas for process improvement.
• Limited self-pay collections, with a lack of patient calling services to handle this segment effectively.

Faculty Profile

• Location: Ashville
• Organization size: Large size
• Specialty: Ambulatory Surgery Center

Issues Detected

• A high volume of 0-30-day claims needs prompt follow-up to avoid aging.
• A substantial portion of AR is in the 90+ day category, leading to delayed collections.
• Frequent coding denials impacting revenue.
• Limited patient engagement for self-pay collections, affecting cash flow.

To see the results download our case study