Revenue integrity for Iowa group homes & NEMT Des Moines, Iowa

Stop losing Medicaid revenue you’ve already earned.

I build custom tools that catch denials before you submit and flag authorizations before they lapse, so you are always ready for a survey. Everything runs on equipment you own, which means patient data never leaves your building.

5 yrs
In direct care
Worked hands-on with people with mental disabilities. I know what the paperwork stands for.
10+ yrs
Bank credit risk & analytics
Spent a career finding where money quietly leaks and records stop matching.
$4M
Business built from scratch
Helped grow a small company into multi-million dollar revenue. I know the owner’s side.
The story

Three careers that don’t usually meet.

Why I see revenue risk where most people see admin

Most people in this work are good at one part of it. I ended up living three.

For five years, I took care of people with mental disabilities. I was in the homes. I learned what the paperwork actually stands for, because I was the one writing the notes at the end of a long shift, getting the signatures, keeping the file right while also keeping a real person safe and looked after. I know what it feels like when the documentation is the last thing you have energy for, and I know what it costs when it slips.

Then I spent over a decade in credit risk and analytics at a major bank. My job, day after day, was to find the place where the numbers stopped matching. Where money was leaking. Where a record didn’t line up. Where something looked fine on the surface and was wrong underneath. That kind of work rewires how you see things. You stop trusting the summary and start checking the detail.

Most losses aren’t dramatic. They are small, quiet, and repeated, and they add up to real money.

Alongside all of that, I spent years learning how to start and grow small businesses. I helped build one from almost nothing into a multi-million dollar company, doing the marketing, the content, the reputation, the growth. So I know the owner’s side too. I know what it’s like to watch cash flow, chase growth, and carry the whole thing on your back.

Here is what those three things did to me. I can’t look at a group home or an NEMT business now without seeing the revenue risk sitting inside it. A care note that never got signed. An authorization that quietly expired. A trip the broker underpaid that nobody caught. To most people those are just admin. To me they are the exact pattern I spent a career hunting down at a bank, except now it is real money walking out the door of a business that earned it.

That’s the part that gets me. Good operators do hard, important work and still lose revenue they were owed. Not because they did anything wrong, but because nobody was watching the seams. The care gets delivered, the trips get run, and the money quietly falls through gaps that no one set up the systems to catch.

So that’s what I do now. I build small, custom systems that catch the gap before it costs you, recover the money that has already slipped, and make sure your records hold up when someone comes looking. I think about it the way a bank taught me to, I build it the way a business owner actually needs it, and I respect the work because I have done the care with my own hands.

Vince Vincent
Healthcare revenue-integrity & compliance systems
01–04
The work

Four focused tools that protect what you earn.

Each one is small, custom, and built around the payers and template you already use. You are not bending your agency around someone else’s platform, and you are not paying by the hour. The price is always a fraction of the revenue the tool protects. Start wherever it hurts most.

Service 01 · Start here

Plan Intake Automation

“Stop hand-typing service plans.”

Every Person-Centered Service Plan your payers send gets turned into your standard internal template automatically. What used to take a couple of hours by hand now takes a few minutes, and it comes out the same way every time.

  • A dedicated extractor per payer so when one changes its format the others keep working.
  • Your consolidated template, editable by your own staff.
  • A simple drop-folder workflow with a six-year audit log and no PHI in the log itself.
Investment
Priced to value
A fraction of the staff time it saves. Your assessment puts a real number on that, then this is scoped against it.
Scope this →
Service 02 · Revenue protection

Pre-Claim Documentation Check

“Catch the denial before you bill it.”

Before claims go out, every billable service gets checked against its authorization and the documentation it needs. Problems get caught at the source instead of bouncing back as denials and clawbacks a few weeks later.

  • Valid, active authorization confirmed for every service.
  • Units actually remaining checked before anything bills past what was approved.
  • An exception report you can act on, while there is still time to fix it.
Investment
Priced to value
A fraction of the denials it prevents. Your assessment puts a real number on that, then this is scoped against it.
Scope this →
Service 03 · Revenue protection

Authorization & Re-Auth Tracker

“Never deliver an unbillable unit.”

A live view of the units left and the re-authorization deadlines for every participant, with alerts that reach your team before anything lapses. It closes the most common gap between the services you deliver and the ones you can actually bill.

  • Units authorized against used, per participant, always current.
  • A countdown to every expiry, sorted by what is most urgent.
  • Advance alerts so you stop finding out only when a claim is denied.
Investment
Priced to value
A fraction of the revenue it recaptures. Your assessment puts a real number on that, then this is scoped against it.
Scope this →
Service 04 · Compliance

Audit & Survey Readiness

“Walk in already prepared.”

It pulls together the exact records an auditor or state surveyor will ask for and checks them for completeness, so you find the gaps before they do. Audit season stops being a fire drill and turns into a file you can hand over.

  • Your audit checklist encoded, per payer and per state.
  • Records assembled automatically, ready to present per participant.
  • Gaps flagged early, as a repeatable routine you run every cycle.
Investment
Priced to value
A fraction of the clawback risk it removes. Your assessment puts a real number on that, then this is scoped against it.
Scope this →
05
Non-emergency medical transportation

Run transport too? There is a second place you are losing money.

Iowa’s non-emergency transport now runs through one broker, MTM Health, which took over Access2Care. It sits under the same MCOs you already deal with: Iowa Total Care, Molina, and Wellpoint. What the broker actually pays you rarely matches the trips you completed, and that difference is money you earned and never collected.

Service 05 · Revenue recovery

Broker Remittance Reconciliation

“Find every dollar the broker didn’t pay you.”

Brokers pay by electronic remittance, and those payments quietly come up short. A trip denied here, a short payment there, a run that never gets paid at all. This lines up every trip you completed against what was billed and what actually got paid, then shows you the difference while there is still time to claim it back.

Remittance files decoded into a plain ledger of what was paid, denied, or short-paid.
A three-way match of trips completed, claims submitted, and dollars received.
Silent denials and short-pays flagged, the losses nobody has time to chase down.
A prioritized recovery worklist, ranked by dollar value, inside the filing window.
Investment
Priced to value
A fraction of what it recovers, or a share of what we bring back. Your assessment puts a real number on the gap first.
Scope this for my fleet →
Also built for transport providers

Three of the tools above carry straight over.

Pre-claim trip scrubbing
Eligibility, prior auth, the right HCPCS and origin or destination modifiers, timely filing, and the signed manifest, all checked before a trip is billed. A missing manifest is the number one reason trips get denied.
Credentialing tracking
Driver licenses, certifications, inspections, insurance, and broker re-credentialing, tracked with alerts ahead of time so a lapse never turns a completed trip into one you cannot bill.
Audit and False-Claims readiness
Manifest, signature, and credential records pulled together and checked for gaps. Billing for trips you cannot fully document counts as billing for services not rendered, and that is a serious risk.
06
How it works

Custom, local, and you always know who is accountable.

No platform lock-in, no patient data shipped to the cloud, and no ticket queue between you and the person who built your system.

Step 01

Discover

An on-site session watching your staff work, plus redacted samples from each payer, to capture the rules nobody has written down.

Step 02

Build

I develop and test on my own equipment using redacted samples, so your real data is never part of the build.

Step 03

Deploy

Installed on a workstation you own. Processing stays in your building, with no remote access after install.

Step 04

Support

As payer formats and rules change, I send you updates you can install. No surprise rewrites.

Local-first by design

PHI stays on your equipment. No third-party cloud touches patient data, which is also the simplest path to staying compliant.

Audit-grade data work

Reconciliation and validation are the whole point here, not an afterthought bolted onto a generic tool. It comes from years of doing exactly this in bank credit-risk analytics.

Compliance handled properly

Every engagement runs under a signed Business Associate Agreement, with appropriate liability protection and record retention built in.

One accountable person

You talk to the person who designed, built, and maintains your system, from start to finish.

The first step

Find out where you are losing money.

Before any build, I take a close look at how your service plans, authorizations, documentation, and claims actually move through your agency. Then I show you the three to five gaps that are costing you the most, with a real dollar figure on each. You keep that roadmap even if we never build anything together.

Paid engagement
Revenue-Integrity Assessment
$2,500 to $5,000
2 to 3 weeks · fixed fee · this is what sets the price for any build that follows
Request an assessment →