The client is a premier 24-hour freestanding emergency room facility
The client faced the following challenges:
- Insufficient in-house billing resources
- Shortage of certified medical coders
- Multiple loopholes in the insurance verification process
- Significant delays in payment posting
- Major dip in payment collection
- Inefficient billing processes
- Piled up AR
The Plutus Health Plan
Plutus Health Inc implemented the solution step by step and gradually got more accurate billing. We used the following techniques to solve the problem:
- To keep the process on track and measure the progress, we had set timelines for each method process improvement
- Imposing the charge reconciliation process made billing gradual and measured and accurate
After we provided the solution, we were in constant touch with the client and had regular follow-ups with them to ensure everything was functioning smoothly.
- The client's overall collection increased from $4 million to $10 million per month in just three years.
- The client's first pass collections increased from 60% to 85%.
- The gross collection ratio increased from 15% to 40%.