Your Medicaid revenue is leaking. We put a number on it.
Denied claims, patients dropped at redetermination, wraparound payments that never reconcile — the losses hide as self-pay visits and quiet write-offs. LumenHealth analyzes your own remittance and eligibility data and shows you what they add up to. Built for FQHCs, look-alikes, rural health clinics, and CCBHCs.
Coverage churn is now a revenue cycle problem.
When nearly half your revenue is Medicaid and your patients must re-prove eligibility twice a year, enrollment volatility flows straight into your collections. Most health centers can't see what it's costing them, because the losses never appear as a line item — they appear as self-pay visits, aged AR, and write-offs that look routine. The first step isn't new software or more staff. It's knowing the number.
What we do
The Medicaid Revenue Diagnostic
A fixed-scope analysis of roughly twelve months of your remittance, claims, and eligibility data. Weeks, not quarters. A defined deliverable, not an open-ended engagement.
Find it
Denials by root cause, coverage churn from redetermination, PPS wraparound gaps, encounters that never became clean claims.
Quantify it
Each leak gets a dollar figure derived from your own 835s and eligibility files — a CFO-ready findings report you can take to your board.
Recover it
A prioritized recovery plan ranked by dollars and effort — actionable whether you execute in-house or with us.
Who it's for
Safety-net billing isn't private-practice billing.
FQHCs & look-alikes
PPS rates, wraparound reconciliation, sliding fee, UDS — the rules generalist billing vendors get wrong.
Rural health clinics
All-inclusive rate billing with a small office wearing five hats — and no slack for denials follow-up.
CCBHCs
PPS billing on top of behavioral-health carve-outs and the highest-churn patient population in Medicaid.
HCCNs & PCAs
Network-level revenue visibility across member centers — where one diagnostic methodology can serve many.
Safety-net specific. AI-native. Methodology in the open.
We work exclusively in community health. Our analysis runs on AI-native tooling — which is why a diagnostic that would take a consulting team a quarter takes us weeks — and we hold that tooling to the standard we've published: every finding traceable to your own remittance data, no black-box estimates. The same rigor behind our published AI governance methodology now applied to the revenue cycle. No vendor money, no referral fees, no products to sell.
Thirty minutes. Your payer mix, your numbers, no pitch.
Built for CFOs, finance directors, and billing managers. If the diagnostic isn't a fit, the call will still tell you where to look.