How Technology Turns the Tide on Uncompensated Care
Unpaid medical services put enormous financial pressure on the healthcare industry. And the pandemic has expanded this financial toll. Many patients have lost their jobs and consecutively their employee health benefits. They are no longer able to pay their healthcare costs. This, combined with a surge in new patients due toCovid-19 has compounded uncompensated care.
But with the rise of new healthcare technology, billings train can be reduced. Typically, medical automation systems help providers by streamlining processes quicker than a human worker. As hospitals adopt these new methods, their efficiency increases.
To improve revenue cycle management (RCM), providers must commit to the best tools at their disposal. Here’s how technology can positively impact healthcare costs.
Eligibility Determination
When done by hand, determining a patient’s eligibility for coverage is highly time-consuming. Public healthcare requirements differ from private requirements, and each company has its own set of standards. Artificial intelligence (AI) is coming into the field to improve efficiency. In the context of eligibility, AI can do a few things.
● Discover which patients need care first
● Find which coverage patients have even without an insurance card
● Create a structured schedule to get those patients medical care quickly and have checkups afterward according to their need
● Allocate resources toward medical projects that have a high chance of success
A health system in Idaho saved 60 staff hours by adopting an automatic financial screener. This screener was 88% accurate and required minimal input from patients. Such programs are crucial in avoiding unnecessary charity write-offs.
Outsourcing eligibility determination is a fast and seamless way to check if your patients are covered before you provide care. This automated process gives your medical office the time to focus on other important matters while fully confident that patient eligibility is taken care of.
Bedside Tablets
Tablets are an integral part of a modern physician’s workday. These devices combine technology and healthcare with programs that seta strict, efficient workflow. Once in the room with the patient, the tablet provides a clear list of questions and follow-up questions.
This automated process helps determine what care the patient is eligible for. It also gives Physicians quick access to patient information so they can efficiently identify where the patient needs care and move them onto the next step.
This process helps avoid leaving out crucial information. With online storage, these tablets can instantly archive the patient’s data for any facility they use in the future. It also gives doctors the knowledge needed to offer faster advice and relieves the patient from unnecessary financial burden.
Online Options
With the difficulty of finding a spot in a hospital, many patients experience long waiting periods. Those who are admitted frequently find the staff unable to help them to the level required. This frustrating patient experience also extends to accessing administrative information.
Thankfully, there is a helpful alternative to this situation. Websites allow patients to fill in information from their homes. While these programs sometimes struggle to ask every question correctly, constant QA testing improves them every day. Before care, patients can find what coverage they qualify for and price shop accordingly. After care, they can get the help they need covering their bills.
Having clear, accessible financial information reduces stress and boosts satisfaction. Once patients understand their coverage, they can contribute far more knowledge to a health system.
Knowledge Boosts
The rise of data analytics in healthcare has given us access to a level of information unheard of prior. As such, physicians can provide personalized care. This care increases efficiency and the chances of successful treatment. The sooner a patient is helped, the less they are required to pay.
AI analyzes healthcare data and finds connecting patterns. These patterns help treat people with similar conditions to previous patients. Physicians can observe similarities between a diagnosed case and an undiagnosed one. Recognizing these signs early is crucial for disease prevention. Both care effectiveness and bill payments improve with more data.
Outsourced Services
If you’re looking for technology to quickly track patient records, determine eligibility, manage claims, and much more, consider outsourcing these services. A competent RCM organization can advise your staff on implementing technology that will speed the process and reduce patient debts and denials.
Plutus Health offers end-to-end RC solutions and works with you to increase your overall revenue. If you are struggling with billing, collection, and management, our expert team takes care to get the fastest reimbursement possible and increase your practice’s performance.
Key Takeaways
1. Artificial intelligence provides an easy way to gather information and creates workflows.
2. Bedside tablets give doctors a clear list of where to go and what to ask.
3. Websites reduce the stress on physical locations and present all necessary information.
4. More information gives providers the tools to treat patients in a specific, efficient manner.
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FAQs


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.


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.


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.


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.


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%.


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.


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.


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.
FAQs


ABA therapy billing is the process of submitting claims to insurance or Medicaid for Applied Behavior Analysis services provided to individuals with autism or developmental disorders. It includes using correct CPT codes, proper documentation, and adherence to payer-specific policies.


Common CPT codes for ABA therapy in 2025 include:
- 97151 – Assessment and treatment planning
- 97153 – Direct therapy with the patient
- 97155 – Supervision and modification of behavior plan
- 97156 – Family adaptive training
- Always check with payers for any annual changes.


To bill Medicaid for ABA services, providers must ensure credentialing is complete, services are pre-authorized, and claims use the correct codes and modifiers. Medicaid requirements vary by state, so always follow state-specific billing rules.


Common ABA billing mistakes include:
- Incorrect or missing CPT codesplan
- Lack of documentation or treatment
- Uncredentialed providers rendering services
- Submitting duplicate or late claims


Without proper credentialing, providers can’t get reimbursed. Insurance and Medicaid require that BCBAs, RBTs, and organizations are credentialed and contracted. Delays in credentialing often cause revenue losses and claim rejections.
FAQs


CMS proposes a 2.4% increase in Medicare ASC payment rates, contingent on meeting ASCQR quality reporting requirements. Plutus Health helps ASCs meet these compliance benchmarks by integrating quality reporting data into RCM workflows, ensuring eligibility for full payment updates.


The ASC Covered Procedures List will expand by 547 procedures, including cardiology, spine, and vascular surgeries. Plutus Health supports expansion into new service lines by customizing RCM processes for high-acuity procedures, minimizing claim denials during the transition.


Site-neutrality narrows the payment gap with hospital outpatient departments, enhancing ASCs' cost-efficiency appeal. Plutus Health helps leverage this advantage in payer negotiations by providing performance dashboards and cost-justification analytics to secure stronger reimbursement terms.


Complex procedures increase denial risk and slow cash flow. Plutus Health's automation-first RCM model delivers 95%+ clean claim rates, reduces A/R days, and safeguards margins, even as your case mix becomes more complex.