Sixteen pieces. One publishing wave.
June 2026 is the biggest publishing wave in ASP-RCM history. Five new anonymized case studies, five open-access white papers, five newsletter issues, and the recap of our sixth Annual Celebration. Each piece is below in the order it lands by hierarchy of value to your operating team. Skim the page, pick what fits your bottleneck, and read it. No download form, no SDR follow-up.
Five client engagements. Anonymized. With the math.
Three-way match reversed $1.4M of post-pay takebacks.
Authorization, supervision ratio, EHR note at one pre-submit gate. Zero auth-expired sessions for 12 months.
Wrap reconciliation surfaced $2.1M in interim limbo.
Member-encounter reconciliation against published PPS rate. 4,800 unpaid wrap entries recovered in 11 weeks.
DNFB compressed 11d to 4d. $4.8M cash unlocked.
Critical-access hospital, Meditech Expanse. CDI loop closed, payer-rule library built, twice-daily DNFB huddle.
BCBA enrollment cut from 97 days to 22.
14-state ABA chain, 38 BCBAs. Parallel commercial + Medicaid. $1.6M revenue captured that would have sat in limbo.
V28 RAF lift +0.14. $5.8M PMPY recovered.
MA practice, 18-month encounter sample. V28 condition map, suspect generation, recapture campaign, AWV completion.
The ABA Revenue Engine. Five papers, one system.
The Authorization Ledger: utilization is the master metric.
Approved hours expire silently. The five-step ledger that holds utilization at 85 to 95 percent with zero lapsed days.
The Payer You Cannot See: eligibility and COB defense.
Insurance changes silently mid-episode. The monthly sweep that caps recoupment exposure at one month, not twelve.
Unit Economics of the Session: clean claim engineering.
A clean claim costs $1x, a rework $8x, an appeal $25x. The 97151 to 97156 family engineered to clear first pass.
Fifty-Two Jurisdictions, One Claim: multi-state compliance.
Expansion multiplies the rule surface faster than revenue. The versioned rule library that replaces memory.
The Escalation Ladder: denials as negotiation, not queue work.
Four rungs from payer rep to state regulator, with the regulatory case where 100 percent of denials were overturned.
Five open-access references. No email gate.
The CMS V28 playbook for risk-adjustment coding teams.
2,300 ICD-10 codes re-weighted, 200+ removed, 8-step migration timeline for MA and ACO REACH.
The three-way match handbook for ABA billing teams.
Auth tracking, supervision ratio, EHR note matching across 97151-97158. The 20 Pre-Flight Validator rules.
NCR over GCR: an honest collection framework for FQHCs.
Why GCR misleads under PPS. NCR by payer class. AR aging on date-of-service. T1015 denial taxonomy.
The 80 denial patterns reference for RCM operations.
80 active denial root causes. Per pattern: CARC/RARC, payer mix, prevention rate, recommended correction.
Cutting BCBA credentialing from 97 days to 22.
Parallel commercial + Medicaid pipelines, NPPES auto-enrich, BACB lookup, Pre-Flight Validator, RS256 Passport.
Three franchises. Five fresh issues.
Authorization gaps and the recapture playbook.
Auth-expired session billing is the largest preventable category in ABA. Six-step recapture playbook. Pre-Flight gate.
RAF attribution: where the lift actually comes from.
Suspect-driven +0.041, recapture +0.058, gap closures +0.024, new diagnoses +0.017 equals +0.14 RAF.
DRG drift: catching the silent capture loss.
CMI compression patterns 2024-2026. Sepsis DRG nuance. Medical-necessity documentation as the CMI lever.
Medicaid rate cuts, credentialing, parent A/R.
Six states cut Medicaid ABA rates. BCBA credentialing at 102 days. Parent A/R DSO at 58 days. What to do.
V28 condition map shifts and the recapture window.
V28 dropped 200+ codes, re-weighted 2,300. The recapture window is tighter than most practices realize.
What landed when. In order.
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