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Recoup

Behavioral health workflow automation

Your clinical care works.The workflow around it is quietly costing you.

Recoup fixes the one behavioral health workflow losing you the most money or staff hours — eligibility, prior-auth and continued-stay reviews, denial prevention, the double-entry between your EHR and biller, or the aged claims piling up. We build the fix inside the systems you already run. Nothing to rip out, nothing for your staff to relearn.

Show me where we’re leaking

Show us how a patient moves from referral to paid. We’ll find the one seam costing you most — free, no obligation.

Patient workflow · referral → paidIllustrative
  1. Referral

    Inbound patient

  2. Eligibility & benefitsleaks here

    Checked by hand — or not at all

  3. Auth / URleaks here

    Continued-stay review slips

  4. Care delivered

    The clinical work happens fine

  5. Claimleaks here

    Documentation gap → denial

  6. Paid

    What actually lands

Illustrative. Your teardown maps your real workflow and names the one seam to fix first.

The problem

None of this is a clinical problem.

You know the pattern. A referral sits in an inbox until the family calls somewhere else. A benefit check that nobody had time to run turns into care delivered against a policy that had lapsed. A continued-stay authorization slips, and the days you were already treating turn into a write-off. Your staff keys the same patient into two systems and reconciles the difference by hand.

None of it is the care. The work happened. The breakdown is in the workflow around it — and most facilities can’t even say which seam is costing them the most.

Where it leaks

  • Referrals that sit in an inbox until the patient picks somewhere else
  • Eligibility checked by hand — or found out, after care, that the policy had lapsed
  • Continued-stay and concurrent reviews that slip, so delivered days never get paid
  • Documentation gaps you catch after the denial, when it’s too late to fix
  • The same patient keyed into the EHR and the biller, reconciled by hand
  • Denied and aged claims nobody had the hours to work, quietly becoming write-offs

If you can see the leak but can’t point to where it’s coming from, that’s the first thing worth fixing.

What we do

We fix the workflow that’s costing you — and leave the rest of your stack alone.

Point at the bottleneck you feel. We build the fix for that one — inside the systems you already run, not a platform you have to buy whole.

Workflow automation

We build the fix for the one operational seam costing you most — intake and referrals, eligibility and benefits, prior-auth and continued-stay tracking, or the double-entry between your EHR and biller — inside the systems you already run.

Denial prevention

We flag the medical-necessity and level-of-care documentation gaps while the claim can still be fixed — so they stop turning into denials you have to appeal after the fact.

Aged-AR & denial recovery

We work denied, underpaid, and aged claims and appeal them before they time out — paid on contingency, a share only of what we actually recover for you.

We do this across the systems you already run. Nothing to install, nothing for your staff to learn.

The menu of bottlenecks

  • Intake & referral follow-up
  • Eligibility & benefits at the door
  • Prior-auth & continued-stay tracking
  • Denial prevention (documentation audit)
  • EHR ↔ billing double-entry
  • Aged-AR & denial recovery

Recovery is one module, not the whole company — the original Recoup, still live and still paid only on what we collect. It’s often where the fastest dollars are, so it’s a common place to start.

Accounts receivable · agingIllustrative
BucketBalance
0–30 days
$312,400
31–60 days
$184,900
61–90 days
$96,250
91–120 daysaging out
$71,800
120+ daysaging out
$128,400
Sitting past 90 days$200,200

Illustrative figures. Your teardown reads your real aging report.

How it works

What working with us actually looks like.

  1. 1

    Show us the workflow.

    Walk us through how a patient moves from referral to paid — or just send your aging report. That’s the whole ask to get started.

  2. 2

    We find the seam.

    We map where the time, errors, and dollars actually leak, and name the one bottleneck costing you most — in plain terms, not a dashboard you have to decode.

  3. 3

    We build the fix.

    We automate or rework just that seam, inside the systems you already run. Nothing to rip out, nothing for your staff to relearn.

  4. 4

    You keep more, sooner.

    Fewer denials, less manual work, faster cash. The recovery work is paid only out of what we actually collect.

Nothing to rip out

Keep your EHR. Keep your biller. We fix the seam.

Every “switch to our platform” pitch asks you to rip out what works and retrain your staff. We don’t. We automate around the EHR, biller, and tools you already run — at the one bottleneck costing you most.

You change nothing about your core systems. There’s nothing to install, nothing for your team to relearn, and finding the seam costs you nothing.

Show me where we’re leaking

Why we built Recoup

We came up inside the systems that are quietly losing you money.

Recoup was built by people who came up inside behavioral health operations — the EHRs, billing systems, and payer logic these facilities run on. We’ve watched referrals go cold in an inbox, eligibility get checked by hand, continued-stay reviews slip, and the same dollars go quiet in the aging report.

That’s why we know which seam to look at first — and why generalist billing shops and horizontal automation vendors keep missing it.

We’re a new firm, and we’d rather be straight about that than dress it up. Here’s what makes us easy to try: start with a free teardown, and judge us on the one bottleneck we find.

No rip-and-replace
We automate around the EHR and biller you already run. Nothing to switch, nothing for your staff to relearn.
Only what you need
We fix the one bottleneck costing you most — one module, not a platform you have to buy whole.
Recovery, paid on results
The aged-AR recovery work is contingency — we earn a share only of what we actually collect.

Where this is going

Fixing the workflow is step one.

Automating the seams where work leaks produces something most facilities have never actually had: a clear, current picture of where their time and money go.

“Where am I losing the most money — and time — right now?”

That’s what we’re building toward — a way to ask your revenue cycle a plain question and get a straight answer back. Running the business with the lights on, instead of guessing.

We’ll get there with the facilities we fix workflows for first. Fixing the workflow proves it out. The visibility is where it leads.

Questions

Questions you’re probably asking.

What behavioral health workflows can you actually automate?

The ones quietly costing you money or staff hours: intake and referral follow-up, eligibility and benefit verification, prior-authorization and continued-stay/concurrent-review tracking, denial prevention, and the double-entry between your EHR and biller. We don’t sell a platform — we build the fix for the one bottleneck costing you most, inside the systems you already run.

How do I automate eligibility and benefit verification before care starts?

We build verification into your intake workflow so coverage, benefits, and authorization requirements are checked at the door — before you’ve delivered care against a lapsed or out-of-network policy. It runs alongside your existing EHR and biller, so your staff stops doing it by hand and you stop finding out too late.

How do I keep continued-stay and concurrent reviews from slipping?

We automate the tracking and reminders around initial auths and continued-stay/concurrent reviews, so the deadline that decides whether delivered days get paid never quietly passes. Your clinical team still owns the review itself; the system just makes sure none of them fall through the cracks of a busy UR queue.

How do I prevent behavioral health denials instead of just appealing them?

We build a documentation check that flags medical-necessity and level-of-care gaps — ASAM and the payer’s own criteria — while the claim can still be corrected, not after it’s denied. Preventing the denial is cheaper than working the appeal, and it’s upstream of the aged AR you’d otherwise have to recover.

Do I have to switch my EHR or replace my current biller?

No. We automate around the systems you already run — nothing to rip out, nothing to install, and nothing for your staff to relearn. We fix the specific seam where work is leaking, alongside whatever EHR, biller, or clearinghouse you already use. Keeping your stack is the entire point.

What happens in a free workflow teardown?

You walk us through how a patient moves from referral to paid — or just send your aging report. We come back with a straight read on where the time, errors, and dollars are leaking, and the one seam worth fixing first. It’s free and carries no obligation. If there’s nothing worth fixing, we’ll say so.

Do you only get paid if you recover money?

For the recovery work, yes — that’s contingency: we take a share of what we actually collect for you, and nothing if we collect nothing. The automation work is priced as a fixed-scope build with an optional monthly to run and monitor it. Either way, the teardown that finds the leak is free.

Can I still recover a behavioral health claim that’s past timely filing?

Often, yes. Timely-filing denials can frequently be appealed when you can document timely submission, a payer error, or another valid exception — but the window to act is short. The older a claim gets, the harder recovery becomes, which is why aged AR is usually the first thing we work and the first thing worth preventing.

What share of claims actually get denied — and appealed?

Denials are common and badly under-worked. According to KFF, roughly 19% of in-network ACA marketplace claims were denied in 2024, yet fewer than 1% of denials were appealed. Most denied dollars are simply written off — which is exactly the gap our prevention and recovery work exists to close. (KFF, 2024)

What’s the difference between you and a generalist AI or automation agency?

A horizontal automation shop will wire up whatever you point at; it doesn’t know where behavioral health revenue actually leaks. We do — concurrent review, medical-necessity and level-of-care denials, carve-outs, per-diem billing, and PHP/IOP rules. We came up inside BH operations, so your payers and failure points aren’t a learning project for us.

How does mental-health parity (MHPAEA) help me appeal a denial?

Parity law requires behavioral health benefits be no more restrictive than medical and surgical ones, which can be grounds to challenge a denial. Note: as of May 2025, regulators paused enforcement of the 2024 Final Rule’s new provisions — but the underlying parity statute and 2013 rule remain in force.

The teardown

Find the workflow that’s costing you most.

Walk us through how a patient moves from referral to paid — or just send your aging report. We’ll come back with a straight read on where the time, errors, and dollars leak, and the one seam worth fixing first — specific to your operation. It’s free, and you’re under no obligation. If there’s nothing worth fixing, we’ll tell you that too.

Prefer to talk first? or email us.

Free, no obligation. We work inside the systems you already run.