Podcast · Community Health Collective · Episode 11
On Jill Steeley’s podcast for community health leaders, the CEO of Fix Healthcare Technology explains why written-off encounters keep becoming billable, and what it takes to catch them before timely filing runs out.
The short answer
In Episode 11 of the Community Health Collective podcast (January 13, 2026), former FQHC CEO Jill Steeley interviewed Howard Archer, CEO of Fix Healthcare Technology, about the fluid nature of Medicaid eligibility. His central point: Medicaid eligibility and benefits change constantly, so an encounter written off as self-pay today can become reimbursable weeks or months later.
Based on FixHT’s 2024 data, an average FQHC can expect about 17% of its uncompensated encounters to become eligible for reimbursement within timely filing. RetroCAID monitors the state Medicaid Benefit Profile of every patient with an uncompensated encounter or balance, every day, and alerts the billing team when an encounter becomes billable.
Also on Apple Podcasts · Episode notes at jillsteeley.com
| Podcast | Community Health Collective |
|---|---|
| Episode | 11: How health centers recover hidden Medicaid revenue |
| Released | January 13, 2026 |
| Length | 40 minutes |
| Host | Jill Steeley, former FQHC CEO and leadership consultant to community health centers |
| Guest | Howard Archer, CEO of Fix Healthcare Technology, with nearly 30 years in healthcare revenue cycle |
Quotes below are lightly edited from the episode for readability.
Commercial coverage starts and stops on fixed dates. Medicaid doesn’t. It can cover care a patient received before they applied, and it keeps changing after it starts. Howard put it this way: patients move in and out of coverage, benefits expand and contract, and payers change.
That’s true even when the front desk does everything right. Eligibility checks at registration are essential, and they work at the patient level on a single date. What happens to that patient’s coverage afterward is a separate question, one that sits at the encounter level. That second question is the one RetroCAID answers.
“Even when the front desk does everything perfectly and determines the patient’s eligibility, they’re really only capturing eligibility on that specific day.”
In the episode, Howard described the kinds of changes that turn a past encounter into a billable one. Each of them happens in the patient’s state Medicaid Benefit Profile:
Howard also noted that the patients most likely to be missed are the ones who visit rarely. A frequent patient’s change in coverage tends to surface at the next visit. A patient who comes in once a year won’t be back before timely filing expires.
Howard said most facilities rely on patients to tell them when benefits finally come through. Some go further and recheck self-pay encounters at set points, such as 30 days, 60 days, or just before sending an account to collections. FixHT calls that back-end practice spot checking. It’s better than nothing, but each recheck still sees only one day.
Monitoring works differently. Rather than asking “is this patient eligible today?”, it watches every uncompensated encounter for any change that could make it reimbursable.
| Spot checking | Benefit Profile monitoring | |
|---|---|---|
| How often | At set intervals (30 or 60 days, pre-collections) | Daily, in the background |
| What it sees | Active or inactive on the recheck date | Any change in coverage, benefit scope or payer |
| Who starts it | Billing staff, encounter by encounter | No one; it runs without a button to push |
| Compared against | Nothing beyond eligibility status | The services provided on that date of service |
| Output | A status for staff to interpret | Only encounters judged reimbursable, with billing details |
Monitoring doesn’t replace front-desk eligibility verification. It picks up after the encounter, once that check has already been done. See how RetroCAID works alongside your existing process.
As Howard described it
A one-hour setup call
FixHT learns the facility’s billing environment and builds two or three reports from its system.
Every open encounter loaded
The reports pull all uncompensated encounters and balances. All of them are run within 48 hours.
Daily Benefit Profile monitoring
Each patient’s state Benefit Profile is watched every day, with data exchanged directly between the state and the facility.
“The rinse”
State-specific rules filter out anything not billable: outside timely filing, not covered by the benefit, or excluded by the facility’s own suppression rules.
An alert to the billing queue
Billers get an email and see what changed, the subscriber ID, benefits and payer, sorted by what expires first.
The facility rebills
The biller updates the existing claim in their own system and submits it for reimbursement.
FixHT keeps a current library of payer handbooks for every state, covering straight Medicaid and MCOs, so timely filing rules are built into each state’s rules. Full walkthrough: How RetroCAID works.
Jill raised the question every health center CEO asks about a new vendor: will it touch the EHR? It won’t. RetroCAID needs no integration and has no software to install.
“It’s practically impossible to find a facility that doesn’t have someone walking around with implementation shell shock on their face.”
Howard said the call is a web meeting that covers three things:
Most of the hour is spent on that billing environment, not the reports.
| When | What happens |
|---|---|
| Day 1 | Setup call. The facility sees how many uncompensated encounters are in its system, usually more than expected. |
| Within 48 hours | Every encounter has been run. The first eligible encounters appear in the billing queue with what’s needed to submit. |
| Within 30 days | Reimbursement typically starts arriving on rebilled claims. |
| Month two onward | Revenue builds as billers work the queue. Howard described it as a snowball. |
The first payout is usually the largest, Jill noted, because it covers a backlog no one has reviewed. After that, monitoring keeps finding new opportunities every month rather than delivering a one-time audit.
Jill came to RetroCAID as a skeptic. She hears from vendors constantly, and her first reaction was that it sounded too good to be true. What changed her mind was seeing the results FQHC clients were getting.
| Figure | What it measures | Source |
|---|---|---|
| 17% | Share of uncompensated encounters that become eligible within timely filing | FixHT 2024 year-end data |
| $9K–$40K | Average monthly recovery range across FQHC clients | FQHC results dashboard reviewed by Jill |
| $58K | First payout for one of Jill’s FQHC clients | Jill Steeley |
| 5,000+ | Facilities served across 49 states plus DC and the Virgin Islands | FixHT |
| ~1 in 3 | FQHCs nationally that use RetroCAID | FixHT |
| 2013 | Launch year, after two years of development inside a Baltimore FQHC | FixHT |
Howard added that size is a poor predictor. Results track the population a facility serves: the more low-income and uninsured patients, the more coverage changes there are to find. Still, he said FixHT has never worked with an FQHC where it didn’t find revenue month to month. Real client figures are on the FQHC results page.
The qualifier, Howard said, is serving patients regardless of insurance status or ability to pay. That includes:
Whether a state expanded Medicaid makes little difference, he said. Some of FixHT’s largest states expanded and some didn’t. What drives missed revenue everywhere is churn: patients moving in and out of coverage.
Pricing and the guarantee
RetroCAID is 100% contingency. FixHT is paid only when the facility is reimbursed. There are no startup, transaction or monthly fees, and every agreement is month-to-month, so a facility can cancel at any time.
The $5,000 guarantee began during COVID, when FQHCs were losing elective and dental visits for months. FixHT wanted to help them offset that loss without looking opportunistic. The response was strong enough that it became a permanent part of every agreement: if RetroCAID can’t increase Medicaid revenue for an FQHC within the first 30 to 60 days of service, FixHT donates $5,000 to the facility or a charity it chooses.
“We don’t want to tell people about this service. We want the opportunity to show them what it can do.” — Howard Archer
Howard expects things to get more chaotic. Medicaid work requirements under H.R. 1 (the One Big Beautiful Bill Act) should mean more churn, more patients cycling in and out of coverage, and more self-pay volume for facilities to carry.
The window is shrinking too. For applications made on or after January 1, 2027, retroactive coverage drops from up to three months to one month for the expansion adult group and two months for other enrollees. With less time to catch each opportunity, waiting for a patient to report new coverage becomes riskier. Details: what OBBBA means for Medicaid eligibility.
For what it means for your facility, see Medicaid’s perfect storm: OBBBA and H.R. 1.
During the public health emergency unwinding, FixHT built a way to flag patients who were losing coverage. Howard said the shortcoming was that it left all the follow-up to the facility. The next step was outreach tools: at the click of a button, a facility can text or email patients whose coverage has lapsed, and send reminder sequences the month before a renewal is due.
That work is now Navicaidor, FixHT’s Medicaid-triggered patient engagement service, which works alongside RetroCAID.
“Facilities are going to have to learn to do more with less. They’re going to need better tools.”
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