Steven Cavan, MS

CriteriaIQ RCM: BH revenue cycle platform. AI med-necessity vs ASAM/MCG/InterQual, auth tracking, denials, billing in one.

[Steven Cavan, MS @StevenCavan]

Your payor reviewer already mapped your documentation against ASAM criteria before the peer-to-peer call. You are responding to a decision, not making your case. CriteriaIQ gives you the same AI analysis so you walk in prepared. Start free: https://t.co/acECC9HQ0Q

[Steven Cavan, MS @StevenCavan]

Credentialing gaps never appear in the demo. They appear three months in, when claims are denied, AR aging is climbing, and the support team cannot explain why. You bought the platform for operational relief. You inherited a problem nobody warned you about.

[Steven Cavan, MS @StevenCavan]

Nobody opens a treatment facility because they love revenue cycle management. They open it to help people. Then the first insurance claim gets denied, the prior auth window closes, and they learn RCM through revenue they cannot recover.

[Steven Cavan, MS @StevenCavan]

The payor runs AI-driven medical necessity reviews against ASAM, MCG, and InterQual. Your facility tracks concurrent reviews on sticky notes and calendar reminders. That gap is widening. The denial rate climbs every quarter while your tools stay the same.

[Steven Cavan, MS @StevenCavan]

Most behavioral health billing companies spend half their day answering where-is-my-auth calls. Every facility wants real-time status. Without a client portal your team is a human switchboard. You did not start a billing company to answer the same question twenty times a day.

[Steven Cavan, MS @StevenCavan]

Most behavioral health facility owners find revenue leakage in the AR aging report after 90 days. The claim is cold. The auth window closed months ago. That money was recoverable at day 30, but nobody could see which aging bucket was bleeding until it was too late.

[Steven Cavan, MS @StevenCavan]

Most behavioral health facilities track denial rate but never measure clean claim rate. Denial rate tells you what already broke. Clean claim rate tells you what is about to break. If it is under 95%, denials climb next quarter regardless of staffing.

[Steven Cavan, MS @StevenCavan]

Most UR nurses walk into a peer-to-peer call hoping to win it. The call was decided by the documentation you produced before the concurrent review. If you cannot cite ASAM criteria in real time, the payor will not extend the auth.

[Steven Cavan, MS @StevenCavan]

Most behavioral health facilities lose an entire authorization over one missing note. A delayed assessment or a gap in the chart gives the payor grounds to deny medical necessity. By the time anyone catches it, the auth window is already closed.

[Steven Cavan, MS @StevenCavan]

Most behavioral health facilities respond to rising denials by hiring another UR nurse. The problem is not staffing. It is a process held together by spreadsheets, shared inboxes, and sticky notes. Adding people to a broken workflow just burns them out faster.

[Steven Cavan, MS @StevenCavan]

@notoveai Friday at 4:57 PM is never an accident. Payors time denials so the appeal window starts ticking while your team is already gone.

[Steven Cavan, MS @StevenCavan]

Nobody opens a treatment facility because they love prior authorization. You opened to treat patients. Then the first claim bounces, the auth window closes, and you learn revenue cycle management the hard way. The clinical work was the easy part.

[Steven Cavan, MS @StevenCavan]

Most behavioral health facilities verify eligibility once at admission. Coverage dates shift. Deductibles reset. Carved-out benefits surface mid-stay. By the time the claim bounces, the auth window is closed and the revenue is gone.

[Steven Cavan, MS @StevenCavan]

Most behavioral health facilities appeal denials one at a time without ever tracking the CARC code on each one. If the same code recurs from the same payer, you have a documentation problem, not a denial problem. Stop appealing blind.

[Steven Cavan, MS @StevenCavan]

Most behavioral health facilities track denial rate but never look at AR aging in 0 to 90 day buckets. A claim past 60 days is usually already lost. By the time you write it off, the upstream UR gap that caused it is repeating on next week's caseload.

[Steven Cavan, MS @StevenCavan]

Most behavioral health billing companies field where-is-my-auth calls from every facility client all day. You did not start a billing company to answer the same phone question twenty times. The ones that scale give facilities a self-serve portal instead of phone tag.

[Steven Cavan, MS @StevenCavan]

Most UR coordinators prep for a peer-to-peer call in the five minutes before dialing. The payor reviewer already ran your notes against ASAM criteria before the call started. You win or lose the auth extension in the documentation, not on the phone.

[Steven Cavan, MS @StevenCavan]

Nobody opens a behavioral health treatment facility because they love prior authorization. You open to help people recover. Then your first denial teaches you auth windows and medical necessity criteria can sink you before your first clean claim.

[Steven Cavan, MS @StevenCavan]

Most UR nurses are not burning out from case volume. They are burning out from the fear of missing one concurrent review deadline among forty. The caseload is manageable. The lack of a system that tracks auth windows across payors is what makes the work feel impossible.

[Steven Cavan, MS @StevenCavan]

Your payor runs your clinical notes through AI against ASAM criteria before the peer-to-peer call starts. Your UR team tracks concurrent reviews on a spreadsheet and sticky notes. That gap widens every auth cycle. Every review you lose starts there.