Reimbursement Watch
Every rate change read and mapped to the borrowers it hits, weeks before it reaches their cash flow.
Why it matters
A fee schedule change or payer policy shift can cut a practice’s cash flow overnight; lenders learn of it at the next annual review.
How the solution handles it
Agents read each CMS, Medicaid and payer rule, map affected procedure codes to each borrower’s volume and payer mix, watch denial trends, and estimate the cash-flow impact, such as the CY 2026 efficiency cut. A portfolio manager decides who to call.
How a rate change moves
Five agents read CMS and payer rules, map codes to borrower volume, track denials and estimate impact; a portfolio manager decides who to call.
What it reads, and what it hands back.
What goes in
- CMS final rules (physician fee schedule, SNF)
- Borrower payer mix and procedure volume
- Commercial payer policy bulletins
- Borrower remittance and denial data
- State Medicaid rate notices
What comes out
- Borrower-level impact estimate
- Rate-change alerts with citations
- Denial-trend watchlist
- Portfolio reimbursement dashboard
Who uses it
The difference, in numbers.
Every figure is labelled: a target the solution is built to, an estimate, a typical published result, or a proven one.
Rules: CMS CY 2026 Physician Fee Schedule final rule (−2.5% efficiency adjustment on many non-time-based services) · “Target” = design goal, measured in the live solution · “Estimated” = our estimate
5 specialist agents. One person decides.
More in this division.
Every practice purchase underwritten on what it collects, not what it bills, with the seller’s handoff checked.
Receivables FinancingMedical receivables valued at what payers actually pay, payer by payer, with denials priced in.
Patient FinancingEvery patient financing file affordability-checked in minutes, with terms in plain words before they sign.
Build this
for your team.
We’ll show Reimbursement Watch running on your own documents.