Medicaid agency billing and intake
A behavioral health agency serving Medicaid clients was doing billing, payroll, intake, and compliance documentation by hand. I co-founded Resolute Services to fix it, and spent the first stretch of the engagement working every role in the building before designing anything.
The problem
Billing a therapist's time to Medicaid took forty to eighty hours a week and was frequently wrong, both in compliance terms and simple human error. Intake took about ten hours per client. Compliance documentation lived on paper. Staff had done it this way for years and had no reason to believe software would make it better.
Who it was for
Therapists, intake staff, billing staff, and managers at the agency, most with no software background. The agency had no internal IT.
What I analyzed
- Every role, by doing it: intake, treatment plans, scheduling, claims, payroll. This is where the real requirements came from, and it is why the finished system matched how people actually worked.
- The Medicaid rules behind the paperwork, so that compliance could be built into the workflow rather than checked afterward.
- Where the errors entered: re-keying the same information into billing that had already been captured at intake.
What I decided, and why
- One operations platform, not a billing tool. Billing errors were downstream of intake and scheduling, so fixing only billing would have kept the errors.
- Storyboard every iteration with the engineer before building. Each cycle began with the process drawn out as user stories, decomposed into screens, so the team built what staff described rather than what the spec implied.
- Treat adoption as half the project. Explaining why, earning buy-in, hands-on training, and follow-up support were planned and delivered alongside the software. Training included SOPs, quick-reference guides, and side-by-side sessions with each staff level.
- Phased rollout, so each module proved itself before the next one changed anyone's routine.
What I built
A management compliance system for Medicaid behavioral health: participant management, therapist tracking, manager administration, automated compliance reporting, and claims generation. Plus the training program and change communications that got it used.
Result
Billing went from 40–80 hours a week to about 15 minutes. Intake went from about 10 hours to 15 minutes per client. Compliance documentation became audit-ready by default. The product was later sold to other local practices.
“At the beginning of each iteration, Christie would sit down with me and, essentially, storyboard the process for me. We would develop user stories that would then be decomposed into individual screenshots and issues.”
Daniel Stephenson, CTO, Resolute Services
