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Updated on:
August 18, 2025
January 3, 2025

5 Steps to Supercharge Your RCM for 2025 Success

Thomas John has 30+ years of experience in healthcare RCM and IT. He is the founder and CEO of Plutus Health Inc., one of the biggest healthcare RCM companies in the US. Thomas has comprehensive knowledge of AI-driven practice management and billing software. He believes in providing an end-to-end solution for revenue cycle and practice management.

ABA Providers Recover Dues From Patients To Efficient Your Account Receivables
"The start of the year is more than just a date on the calendar—it’s an opportunity to set the tone for success. For healthcare providers, optimizing your Revenue Cycle Management (RCM) is the first step toward a profitable and stress-free 2025."

Inside this article:

Meet Sarah, the CFO of a mid-sized healthcare provider. By end of January 2024, her team was already drowning in denied claims, delayed reimbursements, and a mountain of unverified patient data. Their AR days hovered at 52, and the denial rate was a staggering 15%. Sarah knew they couldn’t survive another year like this.

Enter Plutus Health. Through strategic changes focusing on Eligibility Verification (EV), Benefits Verification (BV), and Insurance Discovery (ID), Sarah’s team slashed AR days to 32, reduced denials by 50%, and unlocked an 18% increase in collections.

Here’s how you can do the same.

Step 1: Start with Accurate Eligibility Verification (EV)

Why It Matters:

Did you know that 23% of all claim denials are due to eligibility errors? Missing or incorrect insurance information can lead to costly rework and delayed payments.

What to Do:
  • Use automated tools to verify insurance details in real time.
  • Validate secondary and tertiary insurance coverage upfront.
  • Cross-check demographic details against payer systems.
Results We’ve Seen:
  • Reduced eligibility-related denials by 68%.
  • Improved upfront collections by 15%.
"Think of EV as your first line of defence—it’s the foundation of a clean claim and faster revenue cycle," says Thomas John, CEO of Plutus Health.

Step 2: Simplify Benefits Verification (BV)

Why It Matters:

Patients are responsible for a growing share of healthcare costs, with out-of-pocket expenses increasing by 29% over the last five years. Verifying benefits accurately ensures your team collects what’s owed, without surprises for patients.

What to Do:
  • Automate BV to calculate patient responsibilities and provide upfront estimates.
  • Integrate BV tools into your scheduling and billing systems for seamless workflows.
  • Offer clear communication to patients regarding their financial responsibilities.
Results We’ve Seen:
  • 20% increase in patient payment collections.
  • 10% boost in patient satisfaction scores due to transparency.
"Transparency in benefits verification isn’t just good business—it’s good care," says Plutus Health’s lead strategist.

Step 3: Master Insurance Discovery (ID)

Why It Matters:

In a perfect world, all patient insurance information would be accurate at the point of care. In reality, 18% of claims are delayed due to missing or incorrect insurance details.

What to Do:
  • Leverage AI-powered insurance discovery tools to identify active coverage.
  • Conduct batch processing to validate large patient volumes efficiently.
  • Use predictive analytics to flag potential discrepancies before they become claims issues.
Results We’ve Seen:
  • Identified 99% of active payers through automated coverage discovery.
  • Accelerated claims submission by 30%.
"Insurance discovery turns guesswork into confidence, ensuring no coverage is left on the table," says Sarah, now a vocal advocate of streamlined RCM processes.

Step 4: Broaden Your RCM Strategy

Why It Matters:

While EV, BV, and ID are critical, they’re just the beginning. A broader RCM strategy ensures your team operates efficiently across the entire revenue cycle.

What to Do:
  • Implement predictive analytics to forecast cash flow and prioritize high-value claims.
  • Automate claims scrubbing and denial management for faster resolutions.
  • Monitor key metrics like AR days (DSO), denial rates, and net collection rate (NCR) to identify trends and course-correct.
Results We’ve Seen:
  • Reduced AR days to under 35 for most clients.
  • Increased net collection rates to 96% or higher.
"Your RCM isn’t just a back-office function—it’s your growth engine. Treat it like one," says Thomas John.

Step 5: Prepare for 2025 Trends

Why It Matters:

Healthcare is evolving rapidly, and staying ahead of trends ensures your organization remains competitive.

Key Trends for 2025:

  1. AI-Powered Workflows: Automate routine tasks to free up staff for higher-value activities.
  2. Patient-Centric Billing: Improve patient satisfaction with clear, transparent billing processes.
  3. Hybrid Models: Combine AI-driven efficiencies with human expertise for the perfect balance.
"2025 will reward the prepared. The trends shaping the industry aren’t just predictions—they’re opportunities," says Plutus Health’s innovation lead.

Your Free RCM Checklist for 2025

Ready to supercharge your revenue cycle? Download our free checklist to assess your RCM processes and build a roadmap for success in 2025.

Start the Year Strong with Plutus Health

At Plutus Health, we’ve helped hundreds of providers like Sarah turn their RCM challenges into opportunities. Let us help you streamline your processes, increase collections, and reduce inefficiencies.

"The new year is your chance to get it right. Let’s make 2025 your most successful year yet."

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Faq

What are the top workforce challenges facing ABA therapy providers in 2025?

ABA providers are grappling with high staff turnover (up to 65%), rising burnout, administrative overload, and stagnant reimbursement rates. These challenges directly impact care continuity, clinical outcomes, and operational performance.

How does operational inefficiency affect ABA organizations?

Operational inefficiency costs ABA teams up to 10 hours per staff member per week, contributing to burnout, denied claims, and longer accounts receivable (A/R) cycles. These inefficiencies ultimately result in reduced revenue and patient dissatisfaction.

Why is burnout in ABA clinicians considered a financial risk, not just an HR issue?

Burnout leads to costly turnover, lower client retention, and decreased productivity. Recruiting and replacing a BCBA or RBT can cost up to $5,000 per hire, plus months of lost revenue and disruption to morale.

What are effective strategies for improving ABA staff retention?

High-performing ABA organizations invest in clear career pathways for BCBAs and RBTs, align compensation with market benchmarks, and foster peer-led mentorship, flexible schedules, and wellness programs.

How can ABA organizations reduce the administrative burden for clinicians?

Automation tools like Plutus Health's Zeus streamline eligibility verification, denial management, and billing, reducing manual workloads by 5–10 hours weekly per clinician and improving clean claim rates by 95%.

What's the ROI of outsourcing RCM in ABA therapy organizations?

Outsourcing revenue cycle management can improve collections, reduce denials by up to 30%, and free clinicians from billing-related admin tasks, resulting in better client care and financial outcomes.

What's a proven example of operational transformation in ABA?

One $200 million ABA network partnered with Plutus Health to automate eligibility and accounts receivable (A/R) processes. The result: $2M reduction in legacy A/R and a 97% Net Collection Rate.

How can ABA organizations prepare for value-based care models?

By improving operational efficiency, investing in technology, and ensuring workforce stability, ABA leaders can align outcomes with reimbursement. Plutus Health supports this transition with scalable RCM and automation strategies.

Thomas John, CEO of Plutus Health

Thomas John has 30+ years of experience in healthcare RCM and IT. He is the founder and CEO of Plutus Health Inc., one of the biggest healthcare RCM companies in the US. Thomas has comprehensive knowledge of AI-driven practice management and billing software. He believes in providing an end-to-end solution for revenue cycle and practice management.

FAQs

What are the top workforce challenges facing ABA therapy providers in 2025?
How does operational inefficiency affect ABA organizations?
Why is burnout in ABA clinicians considered a financial risk, not just an HR issue?
What are effective strategies for improving ABA staff retention?
How can ABA organizations reduce the administrative burden for clinicians?
What's the ROI of outsourcing RCM in ABA therapy organizations?
What's a proven example of operational transformation in ABA?
How can ABA organizations prepare for value-based care models?

FAQs

What is ABA therapy billing?
What CPT codes are used for ABA therapy in 2025?
How do you bill Medicaid for ABA services?
What are common ABA billing errors to avoid?
How does credentialing affect ABA billing?

FAQs

How much will ASC Medicare payments increase in 2026?
What's changing in ASC procedure eligibility?
How do site-neutral payments affect ASCs?
Why should ASCs invest in RCM automation in 2026?