Fix Healthcare Technology

What Fix Healthcare Technology does

Fix Healthcare Technology, LLC (FixHT) is a privately held, bootstrapped LLC founded in 2012 and headquartered in Macungie, Pennsylvania. The company develops and operates RetroCAID®, a proprietary retroactive Medicaid recovery service built specifically for safety-net healthcare providers including Federally Qualified Health Centers (FQHCs), FQHC Look-Alikes, Rural Health Centers (RHCs), Critical Access Hospitals, behavioral health facilities, substance abuse centers, and community dental facilities. The platform is implemented as a fully autonomous, deterministic rules-based monitoring engine that continuously reviews patient benefit profiles for uncompensated and self-pay encounters on a daily basis for up to 365 days (or until the timely filing window closes), detecting eligibility denials reversed on appeal, benefit expansions or contractions, and additions of secondary or tertiary payers. When a benefit profile change makes a previously unreimbursable encounter eligible for Medicaid payment, RetroCAID® generates a Patient Benefit Alert (PBA) containing claim-ready billing information for the client's revenue cycle team.

The product is differentiated operationally by requiring no EHR integration or software installation — implementation is completed by phone in under 60 minutes — and commercially by a 100% contingency-based revenue model with no setup fees, transaction fees, or fixed costs, on a month-to-month agreement. FixHT serves more than 4,500-5,000 healthcare facilities across 49 states, the District of Columbia, and the U.S. Virgin Islands, with case-study evidence showing individual FQHCs recovering $172,000 to $297,000 within 2-4 months and average annual recoveries of approximately $90,000 per small-to-medium provider. The company functions as a full-stack technology developer without third-party intermediaries, vendor partners, or external funding, relying on direct consultative sales, content marketing, and client referrals within the community health provider ecosystem to drive adoption.

Name

Fix Healthcare Technology

Legal name

Fix Healthcare Technology, LLC

Website

https://fixht.com

Company type

Private

Founded year

2012

Operating status

Operating

Headcount range

11–50 employees

Short description

Fix Healthcare Technology offers RetroCAID®, a 100% contingency-based retroactive Medicaid recovery service that autonomously monitors uncompensated patient encounters for safety-net providers including FQHCs, RHCs, and community health centers across 49 states, DC, and the Virgin Islands.

Ownership category

akta.pro rank

Product category

Healthcare Revenue Cycle Management Software

SIC

Services-Prepackaged Software (7372)

akta.pro industry

PRIMARYHLAEADAI

Medigap Fraud, Waste & Abuse (FWA) & Payment Integrity

Healthcare & Life Sciences/Health Insurance & Managed Care/Medicare Supplement (Medigap) & Medicare Cost Plans

Keywords

• Retroactive Medicaid recovery
• Healthcare revenue cycle automation
• Medicaid eligibility monitoring
• FQHC billing solutions
• Uncompensated care recovery

Headquarters

HQ city

Macungie

HQ country

United States

HQ region

North America

Markets served

GTM type

B2B

Offering type

Software

Cost components

Technology or R&D, Personnel, Marketing or Sales, Operations

Revenue model

1. Contingency-based Medicaid Recovery: Fix Healthcare Technology operates on a 100% contingency basis. The company earns revenue only when RetroCAID detects changes in patient benefit profiles that make uncompensated encounters reimbursable AND only after the healthcare facility is actually reimbursed by the payer. There are no set-up fees, transaction fees, or fixed costs. The month-to-month agreement can be cancelled anytime.

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels8 records

Core offering

Fix Healthcare Technology sells RetroCAID®, a 100% contingency-based retroactive Medicaid recovery service for safety-net healthcare providers. The platform autonomously monitors patient benefit profiles for up to 365 days, detecting eligibility and coverage changes that convert previously uncompensated encounters into reimbursable Medicaid claims, and alerts billing teams with claim-ready information.

Product overview

Fix Healthcare Technology offers a single unified product, RetroCAID®, a 100% contingency-based retroactive Medicaid recovery service. The platform operates as a standalone monitoring solution that does not integrate with existing EHR or billing systems. RetroCAID® autonomously monitors uncompensated and self-pay encounters daily, detecting changes in Medicaid benefit profiles that make previously unreimbursable services eligible for Medicaid reimbursement. The system generates actionable Patient Benefit Alerts containing billing information needed to submit claims.

Differentiator

Problem solved

Functional benefit

Brands

• RetroCAID®: A proprietary retroactive Medicaid monitoring solution that continuously and autonomously monitors patient benefit profiles for uncompensated encounters to identify reimbursement opportunities.

Products and services

• RetroCAID®

Quantifiable outcome

• Up to $297,134 recovered within 3 months for individual FQHCs
• +4 more outcomes

Named customers11 records

Segments10 records

Ideal customer profiles2 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature4 records

Scale indicators10 records

Recent moves6 records

Expansion highlights4 records

Broad incumbents

• Waystar: Waystar is a leading cloud healthcare revenue cycle platform covering eligibility, claims, denials, and underpayment recovery. Comparable to FixHT because it competes for the same provider wallet around Medicaid/billing optimization, though Waystar is a broad RCM suite rather than a dedicated retroactive Medicaid recovery service.
• Optum: Optum (UnitedHealth Group) operates the largest healthcare revenue cycle management and payment integrity franchise in the U.S., including Change Healthcare. Comparable to FixHT because both target payment integrity and recovery on government healthcare claims, though Optum serves a far broader set of providers and payers.
• Availity: Availity operates a healthcare information network that sits between providers and payers for eligibility, benefits verification, and claims workflows. Comparable to FixHT because both operate at the eligibility/benefit-profile layer for providers, though Availity is an incumbent network rather than a recovery-focused vendor.
• Experian Health: Experian Health provides eligibility verification, claims management, and patient payment/identity solutions to hospitals and physician groups. Comparable to FixHT because both monetize provider-side eligibility and coverage intelligence, though Experian Health is a broad incumbent across RCM functions.

Emerging players

• Paro: Paro provides AI-augmented finance and accounting talent, including RCM support, to healthcare and other industries. Comparable to FixHT because both pursue revenue optimization for providers, though Paro is a talent/AI-services model rather than a standalone retroactive recovery product.
• AKASA: AKASA applies AI/automation to healthcare revenue cycle operations for hospitals and health systems, including eligibility and claims workflows. Comparable to FixHT because both automate reimbursement optimization, though AKASA is an emerging platform with broader RCM scope rather than a dedicated retroactive Medicaid product.

Direct peers

• PMMC: PMMC provides hospital revenue cycle management software and services, including underpayment and contract management recovery. Comparable to FixHT because both monetize recovery of underpaid claims for providers on contingency-style engagements, though PMMC is hospital-focused rather than FQHC-focused.
• MiraMed Revenue Group: MiraMed Revenue Group is an end-to-end RCM outsourcing and consulting provider serving hospitals, physician groups, and specialty providers. Comparable to FixHT because both deliver revenue recovery and billing services to providers and operate on contingency-style engagements, though MiraMed's scope is broader.
• Coronis Health: Coronis Health provides outsourced RCM, coding, and managed care services with explicit focus on hospital and community-provider reimbursement. Comparable to FixHT because both target under-reimbursed encounters and recovery workflows in safety-net and community settings.
• EnableComp: EnableComp specializes in complex claims and underpayment recovery, including workers' compensation and government payer recovery, on a contingency basis. Comparable to FixHT because both sell recovery-as-a-service with contingency pricing aimed at recapturing missed reimbursement for providers.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat5 records

Key risks5 records

Key highlights6 records

Customer concentration

• Xx.com/RetroCAID
• Facebookfacebook.com/FixHealthcareTechnologyLLC
• LinkedInlinkedin.com/company/fix-healthcare-technology-llc

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Fix Healthcare Technology