NewBecker's 2026 Top RCM · Inc. 5000 · Dallas 100
A behavioral health platform grew collections by $2.4M / year with Plutus Health →
SOC 2 Type 2 · HIPAA · BHCOE · CASP
Facility billing is more than submitting claims. ASCs, Freestanding ERs, behavioral health facilities, infusion centers, and other institutional providers each follow different reimbursement rules. Plutus Health combines specialty billing experts with OlympusAI to improve coding accuracy, reduce denials, and recover every dollar your facility has earned.
Get Your Free RCM Assessment →Explore All 25 AI Agents →Facility claim requirements vary by setting and payer. Institutional claims commonly use UB-04 / 837I, while ASC facility claims may follow CMS-1500 / 837P requirements. Our operating model adapts to each setting instead of forcing every facility into the same billing workflow.
We handle implant-intensive outpatient claims by using accurate revenue codes, HCPCS C-codes, proper modifier sequencing, and contract validation to maximize reimbursement and reduce avoidable denials.
Freestanding ER reimbursement depends on accurate facility fees, emergency coding, payer policy, and IDR readiness. We protect both in-network and out-of-network revenue from initial billing through payment recovery.
Behavioral health hospitals, infusion centers, rehabilitation facilities, dialysis centers, and similar providers each follow different billing requirements. Our specialty teams apply payer-specific workflows built for each environment.
OlympusAI automates repetitive facility billing tasks while specialty billing experts manage complex reimbursement decisions. Every claim passes through intelligent validation before submission.
Medical Coding AI validates revenue codes, bill types, modifiers, HCPCS codes, and payer edits against the appropriate claim format and payer requirements, reducing downstream denials.
Agentic AI manages claim tracking, payer status updates, payment posting, and underpayment detection while billing specialists resolve complex exceptions.
Executive dashboards monitor facility-specific KPIs, including denial trends, AR aging, reimbursement variance, and payer performance, to support faster operational decisions.
Every facility claim is reviewed for the applicable claim format, codes, modifiers, payer edits, and supporting documentation before submission to reduce preventable denials.
Payments are matched against contracted reimbursement rates and expected facility payments to identify underpayments and revenue leakage.
Denied and underpaid claims are routed directly to experienced facility billing specialists, who prepare appeals using payer guidelines and supporting clinical documentation.
Our 30-day diagnostic reviews your facility's billing performance, identifies reimbursement gaps, and provides a specialty-specific roadmap to improve collections.
