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October 26, 2022

Freestanding Emergency Room Facility Increased its Collection by 150%

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

The Client

The client is a premier 24-hour freestanding emergency room facility

The Challenges

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 Result

  1. The client's overall collection increased from $4 million to $10 million per month in just three years.
  2. The client's first pass collections increased from 60% to 85%.
  3. The gross collection ratio increased from 15% to 40%.

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