BHW Medical Group — RCM & Billing Command Center

Revenue Cycle Dashboard

Real-time snapshot for BHW Medical Group. Figures shown are sample data pending Notion + Stedi credential wiring.

Charges MTD

—

Collection Rate

—

Denial Rate

—

A/R Days

—

Clean Claim Rate

—

Charges vs. Collections

Trailing 6 months

Sample

Claim Status Mix

Current A/R

A/R Aging

Outstanding by bucket

Collections by Payer

MTD

Priority Worklist

Auto-surfaced

Denials aging > 15d7 claims

Unposted ERAs$18,240

Eligibility re-checks due12 patients

Timely-filing risk3 claims

Charges & Claims

Charge capture and claim lifecycle. Data feeds from the Notion Claims database once connected.

Open Claims

142

Ready to Submit

38

In Adjudication

67

Needs Attention

14

Claim Ledger

Sample · Notion:Claims

Claim #	Patient	Patient ID	DOS	Payer	Program	CPT	Billed	Provider	Status

Payments & Posting

Electronic remits post from the ERA (835) feed automatically. Paper EOBs and cash/check payments get entered by hand below. Everything syncs to the Notion Payments database.

Post a Payment / EOB

For anything that doesn’t arrive as an electronic 835 — a mailed EOB + paper check, or a patient paying cash/check/card.

Payment date

Date of service

Patient (Last, First)

Patient ID

Payer

Method

Check / Ref #

Claim #

CPT(s)

Type

Billed

Allowed

Paid

Patient resp. (total)

Coinsurance

Copay

Deductible

Not covered

Adjustment / denial code(s)

Next appt (if collecting in office)

Posted MTD

$234,480

Unposted ERAs

$18,240

Patient Responsibility

$27,910

Avg Days to Pay

24.8

Collections Trend

Sample

Payment Source Split

Collections — all sources, deduped

Combines Stedi 835, Notion claim payments, and manual EOB/patient postings — each real payment counted once.

Date	Payer	Check/EFT #	Amount	Claims	Type	Status

Denials Management

Maryland-specific denial codes and payer workflows for BCBS Maryland, Medicare, Aetna, and Maryland Medicaid MCO.

Open Denials

37

$ at Risk

$41,620

Appeal Win Rate

68%

Avg Days to Resolve

19.4

Denials by Reason (MD EOB codes)

Denials by Payer

Maryland Denial Code Playbook

Embedded workflows

EOB Code	Meaning	Common Payer	First Action	Appeal Path
EOB 439	Service not covered under member plan	BCBS Maryland	Verify benefits via Stedi; check plan carve-outs	Redetermination w/ medical necessity
EOB 323	Prior authorization missing / invalid	Aetna	Retro-auth request; attach clinical notes	Peer-to-peer within 30d
EOB 539	Duplicate claim / service	Medicare	Confirm not true dup; check ICN linkage	Reopening via MAC (Novitas)
EOB 528	Timely filing exceeded	Maryland Medicaid MCO	Pull proof of timely submission	Good-cause exception filing

Active Denial Worklist

Claim #	Patient	Payer	EOB	Amount	Age	Status

Reconciliation

Two levels: claim-by-claim reconciliation (billed → allowed → paid → patient balance) and payer deposit matching. Every posted payment — electronic 835 or a manual EOB / patient payment — reconciles the claim automatically.

Open A/R

$0

payer still owes

Payer Paid

$0

posted / reconciled

Underpayments

0

paid < allowed

Patient Balances

$0

owed by patients

Claim-Level Reconciliation

Tag each claim to a program & provider as you reconcile — it flows into CPT-by-program and P&L. Adj = billed − allowed; Balance = payer underpayment.

0 / 0 reconciled

Group by program

Claim #	Patient	Program	Provider	Payer	Billed	Allowed	Paid	Adj	Pt Resp	Balance	Status	Bank deposited to	Deposit date	Done

Matched

96.3%

of posted $ this cycle

Open Variances

$3,180

6 items

Last Close

Jun 30

balanced

Reconciliation Worksheet — July

Source	Expected	Received	Variance	Status

Charge Master (CDM)

46 CPT/HCPCS codes from the Notion 💠 Charge Master database. Only G0557 ($125) and 99484 ($100) have confirmed rates today — blanks show “rate not set”, never $0, until the fee schedule is filled in Notion.

Rates pending. Standard Charge and payer allowables are mostly blank in the source database. They’ll populate here automatically as Amaris/Shadé complete the fee schedule in Notion — no rebuild needed.

Fee Schedule

Sample · Notion:Charge Master

CPT/HCPCS	Description	Program	Charge	Medicare Allow.	BCBS MD Allow.

Insurance Verification

Real-time eligibility via the Stedi eligibility API. Enter member details to run a 270/271 check.

● Stedi connected

Straight from Stedi. “Verify Now” calls Stedi’s real-time eligibility endpoint (270/271) through the /.netlify/functions/stedi function and shows the parsed 271 directly — no Notion round-trip. The Recent Verifications table below is Stedi’s own eligibility log; a copy is optionally mirrored to the ✅ Insurance Verification (Stedi) Notion database for record-keeping, but Stedi is the source of truth. You only need to touch rows flagged Needs Review. Until the Stedi key is set, a representative 271 is returned.

Run Eligibility Check (270)

First name

Last name

Member ID

DOB

Payer

Service type

Billing entity

Eligibility Response (271)

Sample

Run a check to see coverage, copay, deductible, and prior-auth requirements. On success it is written back to Notion.

Annual Wellness Visit (AWV) — Medicare

Preventive-benefit signal parsed from the 271 (request service type EA). Traditional Medicare via HETS is most complete; Medicare Advantage plans vary by carrier.

Confirm before billing. The 271 is a strong prompt, not proof. AWV is payable once per 12 months and only the first biller is paid — verify the interval against claims / your MAC before booking it as billable. G0438 = initial (first year of Part B), G0439 = subsequent.

Patient	Coverage	Last AWV	Next Eligible	Status	Recommended

Recent Verifications

Sample · Stedi eligibility log

Patient	Payer	Plan	Copay	Deductible Left	Verified	Status

Payer Contracts

Contract terms, effective dates, and rate schedules by payer.

Active Contracts

Payer	Type	Effective	Renewal	Rate Summary	Status

AI Insights

Narrative intelligence over the full revenue cycle. Each card runs a focused analysis prompt.

Revenue Health

Where is money leaking?

Denial Prevention

Stop denials upstream

Payer Performance

Who pays slow / short?

Cash Forecast

Next 30/60/90

Program Profitability

Which programs earn?

Weekly Narrative

Leadership-ready

Weekly Summary

Live from your claims, collections, and denials — week of —. Wins and watch-list update themselves as the numbers move.

Claims This Week

0

submitted / dated

Collected This Week

$0

payments posted

Open Denials

0

to work

Charges This Week

$0

billed

Wins

Watch List

The Books

Bookkeeping & bank reconciliation. Deposits auto-match to the payments you’ve recorded, every line gets a category, and you split it to a program — so your P&L and each program’s budget stay accurate. Connect the bank once and it syncs on its own.

● Bank · sample

Book Balance

—

— accounts

Deposits In

$0

this period

Expenses Out

$0

this period

Unreconciled

0

deposits to match

Not connected yet. Your accounts are listed below. Click Connect bank once deployed with Stripe keys + Financial Connections on — your login opens in Stripe’s secure window, then transactions sync here and auto-match to your recorded payments.

Accounts

by program

Account	Institution	Balance

By Program

net this period

Program	In	Out	Net

By Category

this period

Category	Amount

Ledger

Every deposit and expense. Category & program auto-fill — adjust any dropdown and it’s saved. ✓ marks a line reconciled to the bank.

Date	Description	Account	Category	Program	Amount	Reconciled

Financial Health

The whole income picture beyond FFS claims — non-claim revenue, the money going back out, and the metrics that tie it together.

Net Collection Rate

—

of collectible $

Non-Claim Revenue

$0

PMPM/incentive/grant/ancillary

Refunds / Recoupments

$0

money back out

Cost to Collect

—

of net collections

Patient A/R

$0

owed by patients

Post Non-Claim Revenue

PMPM / value-based, incentive bonuses, grants, ancillary — anything not tied to a single claim. Posts to the revenue stream and updates P&L.

Date	Source	Description	Stream	Amount

Refunds / Recoupments / Credit Balances

money out

Compliance note. Identified overpayments (esp. Medicare) must be returned within 60 days — track and clear these, don't let credit balances age.

Date	Party	Reason	Type	Amount

Payer Mix

Collections by payer

Provider Profitability

Revenue, cost, and margin by provider — the view Flychain lists as “coming soon,” built on the provider tags you already capture on every claim.

Providers

0

Top by Margin

—

Avg Revenue / Provider

$0

Clinical : Admin

—

payroll ratio

Revenue vs. Compensation by Provider

Provider P&L

Revenue builds from the Rendering Provider on each claim. Enter each provider's annual comp to see margin (saved on this device).

YTD

Provider	Lines	Revenue	Comp (annual)	Margin	Margin %

Revenue by Provider × Program

the breakdown you asked for

Rate Benchmarking

Your allowed rate per CPT vs. Medicare and the MD Medicaid floor — seeded with your real BHW code set and the live Maryland Medicaid fee schedule (1.1.26). Enter your contracted allowed + Medicare per code to see where you’re underpaid.

Below Medicare

0

codes you priced

Est. Annual Upside

$0

to Medicare, at your volume

Below Medicaid Floor

0

should never happen

Avg vs. Medicare

—

Medicare and MD Medicaid rates are real — Medicare Part B non-facility PAR at your QPP/APM rate (Maryland Locality 01, Jan 2026) and your Medicaid Professional Services Fee Schedule (eff. 1.1.26, E/M at the PCP-enhanced rate). Both are pre-loaded and editable. Just type Your Allowed (your contracted commercial rate) per code and it saves on this device; volume for the upside estimate comes from your live claims. (96110 is carrier-priced with no set Medicare rate.)

Your Rate vs. Medicare vs. MD Medicaid

Rate Detail

Your real BHW codes. Edit Your Allowed + Medicare per code; Medicaid is the state floor.

CPT	Service	Program	Vol	Your Allowed	Medicare	MD Medicaid	Gap vs Mcr	Flag

Industry Benchmarks

How BHW compares to physician practices under $5M — NAICS 621111. Benchmark figures are from your industry report; your actuals compute from the P&L as real data flows in.

Profit Margins

higher is better

Spending (% of revenue)

lower is better

Key Industry Metrics

Metric	Industry	Comparison

Liquidity & Cash

Known Industry Risks & What To Do

from your NAICS 621111 report

Revenue Opportunities

Money on the table right now — underpayments, denials, patient balances, and unbilled work — pulled together from across the dashboard, each with the action to capture it.

Opportunities by Category

Computed live from your claims, rates, and balances. Grows as you price contracts and post data.

Opportunity	Est. $	Basis	How to capture

Capture Gaps

Where you billed the base service but missed the companion/add-on. Computed from your live claim mix.

quantified

Missed code	Service	Captured	Eligible	Gap	$ Missed	Note

Recurring Revenue You May Be Leaving

High-value, often-undercoded services — capture on every eligible patient. Rates are your Medicare QPP allowed.

per unit

Code	Service	Medicare (QPP)	Why it's missed / how to capture

Tax Planning

The tax levers healthcare small-business owners most often leave on the table — including the ones most tools skip. Educational, not tax advice — validate each with your CPA.

Practice net income (for a directional estimate)

Est. Annual Savings Gap

$0

directional

Typical Range

$5K–$15K

proactive planning

Levers Tracked

0

Compounds

every yr

not one-time

How to read this. The estimate is directional (built from average ranges), deliberately conservative, and compounds every year you keep the changes. Start with the biggest levers (entity structure + S-corp salary), then work down. A precise number needs your actual books + prior return — treat this as the agenda for a CPA conversation.

Not tax advice. These are common planning areas for healthcare practices; specifics (esp. QBI/SSTB phaseouts, reasonable-comp, and S-corp health-insurance reporting) depend on your facts. Confirm each with a healthcare CPA before acting.

AI CFO

Plain-English answers over your financials, with the KPIs a CFO watches. Ask anything, or start from a prompt.

Net Margin

0%

Net Revenue QTD

$0

Top Payer

—

Clinical : Admin

—

Ask your AI CFO

Real-time analysis over your programs, payers, providers, and cash

Weekly Goal Tracker

Billing throughput against target for the week of June 29 – July 5, 2026.

Charges Billed

Goal $65,000

$61,340

94% of weekly goal · $3,660 to go

Claims Submitted

Goal 120

108

90% of weekly goal · 12 to go

Clean Claim Rate

Goal 90%

91.7%

Goal met ✅

Daily Billing Pace

Sample

CPT by Program

Procedure volume and revenue by clinical program. Filter to one program, or see them all.

Program

Revenue by Program

Top CPT Codes by Volume

CPT Performance

Sample

CPT	Description	Program	Volume	Revenue	Avg Reimb.

Claims Log

Chronological billing log. Mirrors the Notion Claims database.

to

Date	Claim #	Patient	Program	CPT	Amount	Payer	Status	Provider

P&L by Program

Revenue, cost, and margin by program — quarter to date.

Net Revenue QTD

$0

Total Cost QTD

$0

Net Margin

0%

Contribution

$0

Revenue vs. Cost by Program

Margin by Program

Program	Revenue	Direct Cost	Margin $	Margin %

Expense Logging

Operating expenses by category and program — QTD. Tagging an expense to a program flows straight into P&L by Program.

Pick a program to attribute the cost, or leave blank for shared/overhead (allocated across programs by revenue).

Expense Mix

Category Totals (QTD)

Sample · Notion:Business income & expenses

Category	Amount	% of Total

Cost by Program

→ P&L

Program	Direct Cost

Beyond Normal EduMedia Tracker

Content production and revenue for the Beyond Normal EduMedia line.

Pieces Published

24

QTD

Revenue

$38,600

QTD

Avg / Piece

$1,608

In Production

7

Revenue by Content Type

Production Pipeline

Sample

Title	Format	Status	Publish Date	Revenue

Program

Annual Budget

Set your targets — pull them from your LivePlan / business plan. Saved on this device.

Budget vs. Actual (YTD)

—

Revenue

YTD attributed

Direct Expenses

tagged to this program

Item	Category	Amount

Forecast

A living 12-month projection — like LivePlan, but fed by your real run-rate. Set the growth assumptions and it recalculates revenue, expenses, net, and cash on hand, month by month.

Assumptions

Starting values default to your run-rate from actuals. Edit any field — the whole forecast updates.

12-Month Projection

Month-by-Month

Month	Revenue	Expenses	Net	Cash on Hand

Q3 Goals vs. Actual — by Program

Quarter-to-date revenue pacing against Q3 2026 targets for each program. Updates as claim + non-claim revenue is attributed.

Revenue Goal vs. Actual by Program ($K)

Program	Q3 Goal	Actual (QTD)	% of Goal	Status

Payment Recovery Timeline

The BHW 5-phase recovery process — from front-end prevention to final write-off decisions. Each phase has day-by-day action steps and an AI assist.

Phase 1 · Prevention

Day −1 to 0

Phase 2 · Clean Submit

Day 0–3

Phase 3 · Follow-Up

Day 4–30

Phase 4 · Appeal

Day 31–90

Phase 5 · Write-Off

Day 90+

Phase 1 — Prevention (front-end)

Before / day of service

Run Stedi eligibility (270/271) at scheduling and again at check-in; capture copay, deductible, and prior-auth flags.
Confirm prior authorization for any service that requires it (watch Aetna EOB 323 patterns).
Verify demographics, subscriber ID, and coordination-of-benefits order.
Collect patient responsibility (copay/estimate) at point of service.

Phase 2 — Clean Submission

Day 0–3

Scrub claim for CPT/ICD match, modifiers, and units before release.
Submit via Inovalon clearinghouse; confirm acceptance (277CA) within 48h.
Resolve front-end rejections same day — do not let them age.
Log submission timestamp to protect against timely-filing (EOB 528).

Phase 3 — Follow-Up

Day 4–30

Day 7: status-check any claim without acknowledgment.
Day 14: work first denials/rejections; post all ERAs within 48h of receipt.
Day 21: escalate no-response claims to payer rep; document reference #.
Day 30: flag anything unpaid into the appeal queue.

Phase 4 — Appeal & Escalation

Day 31–90

Draft appeal citing the specific Maryland EOB code and medical-necessity basis (439, 323, 539, 528).
Aetna: request peer-to-peer within the 30-day window for auth denials.
Medicare: pursue reopening/redetermination via Novitas.
Maryland Medicaid MCO: file good-cause exception for timely-filing.
Track appeal deadlines; second-level appeal where first is upheld.

Phase 5 — Write-Off Decision

Day 90+

Review remaining balance against cost-to-collect threshold.
Confirm all appeal levels exhausted and deadlines passed.
Route patient-responsibility balances to statements / payment plan before write-off.
Document write-off reason and obtain sign-off; feed pattern back to Phase 1 prevention.

Insurance Discovery

Find active coverage you didn’t know about from just patient demographics — no member ID needed. Turns self-pay / uninsured visits into billable claims and surfaces hidden secondary coverage.

● Stedi · sample

How it differs from eligibility. Eligibility (270/271) checks a plan you already have on file. Discovery takes name + DOB (± demographics) and searches across payers to find coverage — commercial, Medicare, or Medicaid — for patients who presented as self-pay or whose coverage lapsed. Every hit is a claim you would otherwise have written off. Runs through /.netlify/functions/stedi?feed=discovery.

Self-Pay Scanned (MTD)

86

Coverage Found

29

Hit Rate

34%

Est. Recoverable

$21,400

Run Discovery

First name

Last name

DOB

Gender

SSN (optional — full 9 digits gives the best match; last-4 also works)

Street address (optional)

City

State

ZIP

Date of service

Name + DOB is the minimum. Adding a full SSN or a street address sharply improves matching. Everything is sent securely to Stedi server-side (never in a URL) and isn’t stored on this page.

Discovery Result

Sample

Run a discovery to find active coverage. Any coverage found can be sent straight to Eligibility to confirm benefits, then billed.

Recent Discoveries

Self-pay coverage found → convert to billable

Patient	DOB	Discovered Payer	Member ID	Plan	Est. $	Result

Claim Status 276 / 277

Live “where is my claim” pulled straight from Stedi — no manual portal checks, no Notion round-trip. Each row is the latest 277 response from the payer.

Not checked yet ● Stedi · sample

How this replaces manual work. Instead of logging into each payer portal, the app batches a 276 status request through /.netlify/functions/stedi?feed=claimStatus and parses the 277 back. Claims that finalize as paid flow to Payments; anything denied drops into the Denials worklist automatically.

In Process

63

Finalized · Paid

41

Finalized · Denied

8

Pending Info

6

Avg Age (days)

12.4

Status Category by Payer

Current open claims (277 category)

277 Category Mix

Live Claim Status

Stedi 277

Claim #	Patient	Payer	Submitted	277 Status	Charge	Age	Category

Remittance / ERA 835

Electronic remits parsed straight from Stedi — paid, adjusted, and denied at the line level with reason codes. Feeds Payments and Denials directly.

● Stedi · sample

ERAs Received

6

this month

$ Posted

$0

Auto-Posted

—

Exceptions

0

⚑ Downcoding Watch

Lines where the payer paid a lower-level code than billed — the “systematic downcoding” pattern (see Sources)

Detected by comparing the CPT you billed against the CPT the payer adjudicated in the 835. A rising delta on a single payer is the fingerprint of an automated downcoding algorithm — flag, document, appeal.

Claim #	Payer	Billed	Paid As	Program	$ Lost	Pattern

Remittances (835)

Click a remit to break it down to claim & service line — with a note field per claim

Stedi

	Payer	ERA #	Check / EFT	Date	Amount	Claims	Posting

Adjustment Reasons

CARC/RARC mix

Payers & Enrollment

Stedi’s payer directory and your transaction enrollment status per payer — which payers are live for eligibility, claims, and ERA.

● Stedi · sample

Enrollment gates your live feeds. Eligibility and claim status work as soon as a payer is enrolled in Stedi; ERA (835) delivery requires a separate payer enrollment. Rows marked Pending are enrollments in flight — those payers stay on manual until they clear.

Payers Live

9

Enrollment Pending

2

Eligibility Enabled

11

ERA Enabled

7

Payer Enrollment Matrix

Stedi payer directory

Payer	Stedi Payer ID	Eligibility	Claims	ERA (835)	Status

Population Health Management

Managing the whole attributed panel — not one claim at a time. Risk, care gaps, chronic disease, and the value-based revenue that follows. Built for a fast-growing primary care practice.

Attributed Panel

3,140

active patients

Rising-Risk

218

intervene now

Open Care Gaps

486

across measures

CCM / RPM Enrolled

248

of 640 eligible

MIPS Projected

82.5

composite

Risk Stratification

Panel segmented by clinical + utilization risk — the rising-risk band is where dollars and outcomes move

Value-Based Revenue at Stake

Annualized opportunity

CCM / APCM (99490, 99491)$184,300

RPM (99457, 99458)$96,400

TCM post-discharge (99495/6)$41,700

Quality / MIPS adjustment$63,800

Total unrealized$386,200

Chronic Conditions

Registry snapshot

Care Gaps by Measure

Open, top 6

Rising-Risk Worklist

Auto-surfaced

Uncontrolled A1c > 9%37 pts

BP > 140/90, no recheck 90d54 pts

ED visit, no PCP follow-up19 pts

Polypharmacy ≥ 10 meds28 pts

Care Gaps & Chronic Registry

The preventive-care and chronic-disease registries that drive quality scores and value-based revenue. Close the gap, capture the measure.

Open Gaps

486

Closed MTD

112

Closure Rate

64%

Est. Visit Revenue

$71,400

Open Gaps by Measure

Chronic Disease Registry

Sample

Condition	Patients	Controlled	CCM Eligible	Enrolled

Care Gap Worklist

Sample

Patient	Measure	Last Done	Due	Program	Status

Hospital Visits & Transitional Care

Admissions, discharges, and ED visits across your panel (CRISP ADT feed) — surfaced so no discharge slips past the TCM window. Post-discharge follow-up is better care and billable (99495/99496).

● CRISP · sample

Where the data comes from. Admit/discharge/transfer (ADT) events arrive from CRISP (Maryland’s HIE) via its CEND / ENS service — CRISP matches the patient panel you submit against live hospital ADT. TCM billing requires interactive contact within 2 business days of discharge and a face-to-face visit within 7 days (99496, high complexity) or 14 days (99495, moderate). The clock below is computed from each discharge date. Set complexity per discharge with the toggle in the Action column — a clinical call that moves the visit deadline and the billed code, and the clock instantly recomputes.

Panel last synced to CRISP: — · resubmit every ≤90 days

Admissions MTD

34

Discharges (7d)

11

TCM Windows Open

7

30-Day Readmit

9.2%

TCM Revenue MTD

$8,900

ADT & TCM Worklist

CRISP CEND · TCM clock

Patient	Event	Facility	Date	Disposition	TCM Window (computed)	Action

Quality & MIPS

Your value-based scorecard. Medicare is shifting more payment onto measured performance — this is where quality becomes reimbursement.

Why this matters more each year. Under the Medicare quality payment program (and the proposed data-driven performance payment framework in Sources), a growing share of the fee schedule rides on your composite score. A strong score is a positive adjustment; a weak one is a penalty on every Medicare claim.

Composite

82.5

threshold 75

Quality

78

30% weight

Promoting Interop

85

25% weight

Cost

71

30% weight

Proj. Adjustment

+5.4%

Category Performance vs. Benchmark

Composite Weighting

Quality Measures

Sample

Measure	Type	Performance	Benchmark (decile)	Points	Status

Participation Status & The Decision

PY 2026

Status: Opt-in eligible (individual & group). Exceeds only 1 of 3 low-volume thresholds — not required to report.
Practice: Baltimore Healthcare & Wellness, LLC — Amaris (NPI 1841844222) + Yahaira (attached Jun 2026). Adding Yahaira does not make the group required for 2026.
Special status: Small practice HPSA — +6 Quality bonus, PI/Cost reweight likely. Path = traditional MIPS (no APM).
Path: Report once as a GROUP (covers both providers, one filing, both get the adjustment).

You only get paid if you OPT IN. Voluntary reporting = $0 adjustment. The opt-in election is made at submission (Jan–Mar 2027) and is irrevocable. Opt in only if the projected composite clears 75 — otherwise you take penalty risk for a small upside (Part B base is under $90k).

Deadlines & Milestones

Now (Aug 2026) — verify 6 measures; capture both outcome measures; check Yahaira's QPP statusAmaris

~Oct 3, 2026 — start continuous 90-day Improvement Activities windowAmaris

Ongoing — log counts monthly; hold the 75% data-completeness floorAmaris

Dec 31, 2026 — performance year ends; data locks—

Jan–Mar 2027 — submit & ELECT OPT-IN as group (the money step)Amaris

Jan–Dec 2028 — payment adjustment applies to Part B claims—

Confirm exact submission & election dates at qpp.cms.gov — CMS sets them each year. Full tracker: BHW-MIPS-2026-Quality-Tracker.xlsx.

MIPS Resources — Downloads

Team

Working files for the MIPS 2026 opt-in + Flow vascular screening rollout.

⬇ Quality Tracker (.xlsx) ⬇ Team Rollout Brief (.docx) ⬇ Biller Quick-Reference (.docx)

Sources & Method

What this dashboard is built on — the standards, benchmarks, and references behind each section. Figures shown in the app are BHW sample data until live credentials are wired.

Data & Integrations

Stedi — clearinghouse & healthcare APIs (eligibility 270/271, insurance discovery, claim status 276/277, remittance 835, payer directory / enrollment). Live feeds source directly from Stedi.
stedi.com/docs Public OpenAPI specs
Notion — system of record for practice tracking (claims log, charge master, contracts, expenses, weekly scoreboard, goals).
CRISP CEND / ENS — Maryland HIE hospital admit/discharge/transfer feed powering the Hospital & TCM worklist and the TCM billing clock. Roster-in (panel CSV, ≤90 days), notifications-out (HL7 ADT).
CRISP CEND

Practice Management & Benchmarks

MGMA — Practice Analytics & Benchmarks. Admin training and benchmark data for independent practices; basis for the KPI targets and A/R / denial benchmarks.
MGMA Analytics demo
MGMA — Financial Optimization for Physician Practices. Assessment & improvement framework informing the P&L and revenue-leakage views.
Read the article
MGMA Analytics benchmark docs (2024 practice analytics packets) — reference for productivity and revenue benchmarks. On file

Denials & Coding Integrity

Adonis — The Rise of Systematic Downcoding. The basis for the Downcoding Watch on the Remittance page: payers algorithmically reducing E/M levels, and how to detect and appeal it.
Read the report
Medicare — data-driven performance payment framework. Reference for the Quality & MIPS section and the shift of fee-schedule dollars onto measured performance. On file (PDF)

Revenue Cycle Method

“Revenue Cycle Management — Don’t Get Lost in the Financial Maze.” End-to-end RCM reference behind the stage model (front-end → submission → follow-up → appeal → write-off). On file (book)
“Roadmaps.” Process-flow reference for the Payment Recovery Timeline phases. On file (book)

Method note. Sample figures are illustrative and BHW-flavored (Maryland payers, your programs) so the workflow is demonstrable before credentials are set. Once Stedi and Notion keys are added, every live-feed section replaces sample data automatically — no rebuild. Benchmarks referenced from MGMA/Medicare should be re-pulled against your current specialty and region before use in contracting.

Monthly Close

Month-end summary (modeled on your billing-summary format) plus the close checklist — computed from live claims. Data-driven flags surface what still needs work before you close the month.

Month

Total Billed

—

Total Collected

—

Denied

—

Open A/R

—

Month-End Close Checklist

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Run in order — each step depends on the one before it being clean. Checks save per month, on this device.

Collection by Payer

Payer	Claims	Billed	Collected	Rate

Denials by Payer

Payer	Denied Claims	Denied $

Provider Breakdown

Provider	Claims	Billed	Collected	Rate

Status Breakdown

Status	Claims	Billed	Collected

Sign in

Revenue Cycle Dashboard

Charges vs. Collections

Claim Status Mix

A/R Aging

Collections by Payer

Priority Worklist

Charges & Claims

Claim Ledger

Payments & Posting

Post a Payment / EOB

Collections Trend

Payment Source Split

Collections — all sources, deduped

Denials Management

Denials by Reason (MD EOB codes)

Denials by Payer

Maryland Denial Code Playbook

Active Denial Worklist

Reconciliation

Claim-Level Reconciliation

Reconciliation Worksheet — July

Charge Master (CDM)

Fee Schedule

Insurance Verification

Run Eligibility Check (270)

Eligibility Response (271)

Annual Wellness Visit (AWV) — Medicare

Recent Verifications

Payer Contracts

Active Contracts

AI Insights

Revenue Health

Denial Prevention

Payer Performance

Cash Forecast

Program Profitability

Weekly Narrative

Weekly Summary

Wins

Watch List

The Books

Connect your bank — one-time setup

Accounts

By Program

By Category

Ledger

Financial Health

Post Non-Claim Revenue

Refunds / Recoupments / Credit Balances

Payer Mix

Provider Profitability

Revenue vs. Compensation by Provider

Provider P&L

Revenue by Provider × Program

Rate Benchmarking

Your Rate vs. Medicare vs. MD Medicaid

Rate Detail

Industry Benchmarks

Profit Margins

Spending (% of revenue)

Key Industry Metrics

Liquidity & Cash

Known Industry Risks & What To Do

Revenue Opportunities

Opportunities by Category

Capture Gaps

Recurring Revenue You May Be Leaving

Tax Planning

AI CFO

Ask your AI CFO

Weekly Goal Tracker

Charges Billed

Claims Submitted

Clean Claim Rate

Daily Billing Pace

CPT by Program

Revenue by Program

Top CPT Codes by Volume

CPT Performance