Solutions
Best-in-class Cutting-edge IOP Billing Solutions for Behavioral Health Services and Substance Use Treatment Providers
AI-powered Technology
End-to-end Revenue Cycle Management
24/7 Support
Proven Success Record
As the best medical billing company, Plutus Health simplifies IOP billing for behavioral health and substance use treatments. Our AI-powered revenue management solutions and 70+ RCM Bots accurately handle complex codes, submit error-free claims, and get you maximum reimbursements.
Supervision Required: The attending provider must supervise the patient at all times.
Adherence to Plan: Follow the initial treatment plan.
Diagnosis Focus: Address the diagnoses that require admission.
Best Practices: Maintain consistency with clinical best practices.
Duration: Expected treatment lasts 12 to 16 weeks.
Turn around time
Our clients have seen their average turnaround time drop to below 48 Hours
< 48Hours
Clean claim percentage
The clean claim percentage for our clients has reached around 95%
95%
Patient collection
Automatic payment collections have increased to 35%
35%
Contracted value collection
The average net collections have reached a remarkable 98%
>98%
Denial rates
Denial rates have been reduced to less than 5%
< 5%
A/R days
Accounts Receivable (A/R) days have decreased to just 25 days
25Days
Billing codes vary based on patient diagnosis and primary services
For dual diagnoses, generally, only one IOP session per day can be billed
Pre-authorization is typically required
Most payers require at least 180 minutes of active therapy per day for per diem rates
Clinical documentation is crucial for supporting claims
At Plutus Health Inc., we specialize in IOP billing, ensuring healthcare providers receive full and timely reimbursement for their valuable services.
Timely submission of authorization requests
Comprehensive clinical documentation to support claims
Ongoing monitoring of authorization expiration dates
Proper billing for patients with dual diagnoses
Integration of care plans to prevent claim denials
Clear communication with insurance carriers
Adherence to payer guidelines for IOP duration (typically 90 to 180 days)
Short-term, acute interventions
Guidance on billing for physician services in different settings
Separately billed for hospital-based programs