It doesn’t just show you the leak. It does the work.

Reconcile and recover the Medicaid wraparound the state owes you — not just report the gap.

• Reconciles MCO-paid against the PPS-equivalent owed, per plan
• Files for the underpaid wraparound inside the reconciliation window
• Stands up a quarterly reconciliation so the gap never reopens

Capture the 34.16% enhanced rate on the visits that qualify — and back-bill the ones you missed.

• Flags new-patient, AWV, and IPPE visits for the enhanced rate at check-in
• Back-bills eligible visits inside the timely-filing window
• Adds an edit so future eligible visits are never missed

Move your PPS rate when your costs and scope have moved — with the evidence to make the case.

• Tracks cost-per-encounter against your current PPS rate
• Surfaces Change-in-Scope triggers as they accrue
• Builds the rate-adjustment case with the supporting numbers

Recover denied and underpaid claims — and stop the repeats — instead of reworking them one by one.

• Groups denials by carrier and reason code, ranked by recoverable dollars
• Drafts the appeal so each one takes minutes, not hours
• Surfaces repeat patterns so they get prevented, not just reworked

Recover the capacity already hidden in your schedule and documentation.

• Per-provider utilization and chart-close lag in one view
• Open capacity quantified in dollars, by provider and site
• No-show patterns turned into schedulable actions

File re-enrollments before a lapse ever stops the billing.

• Tracks payer enrollment and license expirations across providers
• Alerts at 90 / 60 / 30 days so nothing lapses unnoticed
• Flags clinic days that fall inside a possible gap

Track changing grant rules, never miss a deadline, and draft faster — a radar and drafting assistant.

• Regulatory radar: plain-language digests with status, effective date, and source link
• Deadline engine for funding, HRSA SAC/UDS reporting, and renewals — with alerts
• NOFO/RFP drafting assist that maps requirements into a starting draft