Built for PHP & IOP Programs

Stop losing PHP and IOP revenue to documentation denials.

Lucida scores every daily progress note — from any EHR, or even paper charts — against payer and ASAM medical-necessity standards, so you catch the notes that won't survive concurrent review or audit before the payer does.

Built with PHP & IOP leaders who’ve lived through the denials

MN Score

82/100+6

CR Risk Notes

7-4

Clawback Exposure

$47K-18%
Medical-Necessity Score Trend
6M1Y
AI

7 notes flagged for review

Just now

Built with PHP and IOP leaders across the country

Meridian PHP
ClearPath IOP
Lighthouse Recovery
Summit SUD
Horizon IOP
Pathways PHP
Anchor Recovery
Evergreen IOP
Meridian PHP
ClearPath IOP
Lighthouse Recovery
Summit SUD
Horizon IOP
Pathways PHP
Anchor Recovery
Evergreen IOP

Medical necessity is where PHP and IOP revenue dies.

Across every payer, auditor, and denial letter, one failure mode dominates: daily notes that don't prove the patient can't step down to a lower level of care today. It costs programs revenue in three predictable ways.

Initial Auth Denied

Intake doesn't clear ASAM or LOCUS criteria the payer cites. The program admits the patient anyway and eats the claim.

Concurrent Review Cuts

Vague or templated daily notes don't justify continued PHP/IOP intensity. The payer ends authorization mid-stay; every day after is a denial.

Retrospective Clawbacks

Post-payment audits pull notes 12–24 months later. Documentation that doesn't support the LOC billed gets reclassified as overpayment — and the money goes back.

The Silent Cost

Templated copy-paste notes, missing PHQ-9/GAD-7/ASAM scores, weeks under the 20-hour PHP threshold. Nobody audits it until the denial letter arrives.

Platform

One pillar. PHP/IOP Revenue Protection.

Lucida sits on top of the EHR you already use and reads every daily note the same way a utilization-review nurse would — but for every patient, every day, in real time.

Medical-Necessity Scoring, Every Note, Every Day

Every progress note scored against payer and ASAM/LOCUS criteria the moment it's signed. Clinicians see a risk score; leadership sees which patients have documentation that won't hold up under concurrent review.

Documentation
Authorization
Clawbacks

Concurrent-Review Readiness

Auto-compiles payer-ready justification packets from the notes already in the EHR. What used to take a UR nurse four hours takes four minutes.

Clawback Exposure Monitoring

Scans already-paid claims and flags which ones won't survive retrospective audit — so you can fix documentation before the auditor arrives, not after.

Payer-Language Coaching

Suggests ASAM/LOCUS-grade rewrites of weak note sections. Clinicians keep their voice; payers get the specificity they require.

How It Works

From disconnected to intelligent in three steps.

1

Bring your notes

Any EHR, any format — even paper charts or PDFs. Lucida ingests your daily progress notes read-only. We never write back to the chart. No workflow changes, no rip-and-replace.

2

Score every note

Lucida reads every daily progress note against payer and ASAM/LOCUS medical-necessity standards, flags missing elements, and scores the note's audit survivability.

3

Defend your revenue

A dedicated UR-experienced advisor sits with your clinical and billing leaders weekly to act on the risks — fixing documentation, defending authorizations, and neutralizing clawback exposure.

Features

Every layer of medical-necessity risk, covered.

Documentation intelligence at the note, concurrent-review defense at the auth, and clawback exposure monitoring after the claim is paid.

Note-Level MN Scoring

Every daily note scored in real time. Flags missing PHQ-9/GAD-7/ASAM scores, templated language, and absent step-down rationale before the note is ever reviewed by a payer.

20-Hour Threshold Tracker

Live weekly tracker of PHP therapeutic service hours per patient, with proactive alerts the moment a patient is trending below the 20-hour threshold.

Payer-Language Coaching

Inline suggestions that rewrite vague clinical language into the ASAM/LOCUS-grade specificity payers require — without changing the clinician's voice.

Step-Down Rationale Check

Every note is evaluated for whether it answers the payer's core question: why this patient cannot safely step down to a lower level of care today.

Results

The numbers speak for themselves.

0%

of PHP notes fail an ASAM audit*

0x

Faster concurrent-review response*

0 mo

Typical clawback lookback window

0 hrs

PHP weekly threshold we monitor live

Integrations

Works with the tools you already use.

We connect to your existing systems — no rip-and-replace, no workflow disruption. If you use it, we can integrate it.

EHR (PHP/IOP)

Kipu Health
Valant
Alleva
Sunwave

EHR

TherapyNotes
SimplePractice
Netsmart
DrChrono

Billing / Payer

Availity

Billing

CollaborateMD
Kareo

Don't see your system? We'll connect it.

We thought our documentation was fine because the claims were getting paid. Lucida showed us $340K of exposure across already-paid weeks. We fixed the process before a single audit pulled it back.

Design Partner

CFO, Florida IOP network

Design partner program — 10 programs

Prove it against your own notes.
First 45 days on us.

We’re opening ten design-partner slots with PHP and IOP programs who want to co-develop Lucida against their real payers and real clawback exposure. It’s a working partnership, not a freemium tier — and it’s the fastest way for a skeptical CFO to prove ROI before a single dollar changes hands.

Claim a design-partner slot

No card required · No auto-charge · Qualification on a 30-minute call

45 days of Lucida — no cost

Full access to documentation scoring, concurrent-review packets, and clawback monitoring. No card on file. No auto-charge.

Weekly working sessions

Direct time with the founder and our UR-experienced clinical reviewer. We tune the scoring against your payers and your notes.

Lifetime preferred pricing

Design partners lock in an early-adopter rate on the day they convert. If we raise prices later, yours don't move.

Keep every report

Even if you don't continue after 45 days, every risk report, exposure summary, and concurrent-review packet we produced is yours to keep.

FAQ

The questions PHP & IOP operators actually ask.

Quick answers on medical necessity, how Lucida works, and what the design-partner pilot includes.

What is the #1 cause of PHP and IOP claim denials?

Failure to establish medical necessity in daily clinical documentation. Across every major payer, auditor, and denial letter, the single dominant reason PHP and IOP claims are denied, cut mid-stay, or clawed back after payment is that the notes don't prove the patient cannot safely step down to a lower level of care today. Everything else — coding errors, timely filing, auth timing — is a distant second.

What is a retrospective clawback and how far back can a payer go?

A retrospective clawback (or “recoupment”) is when a payer audits already-paid claims, decides the documentation doesn't support what was billed, and recovers the money — often 12 to 24 months after the service, occasionally longer under Medicaid RAC programs. Triggers include length-of-stay outliers, high-volume billing, overlapping level-of-care billing, and random sampling. For a mid-sized PHP/IOP operator, a single retrospective audit can pull back six figures. Lucida's clawback-exposure monitoring surfaces at-risk claims before the auditor arrives.

How does Lucida work with our existing EHR?

Lucida is a read-only overlay on the EHR your program already uses — Kipu, Valant, Alleva, Sunwave, TherapyNotes, SimplePractice, or others. We ingest daily progress notes via API or export, score them against payer and ASAM/LOCUS medical-necessity standards, and surface the risk findings in the Lucida dashboard. Clinicians keep their existing workflow. We never write back to the chart, never change how notes are authored, and never require staff to log into a second system to do their current clinical work.

Is Lucida HIPAA compliant?

Yes. Lucida operates as a business associate under HIPAA when we touch PHI. A BAA is available on request and is required before any paid engagement. All data is encrypted in transit (TLS 1.3) and at rest (AES-256), access is role-based and logged, and our policies align with the 2026 HIPAA Security Rule updates that make encryption mandatory rather than “addressable.” Full details on the security page.

What is the design-partner program?

We're opening 10 design-partner slots with PHP and IOP programs who want to co-develop Lucida against their real payers and real clawback exposure. Design partners get 45 days of full Lucida access at no cost, weekly working sessions with the founder and our UR-experienced clinical reviewer, and lifetime preferred pricing if they continue after the pilot. In exchange, design partners give us access to de-identified notes and denial letters, participate in feedback sessions, and — if it works — let us reference them as a customer.

Find out how many of your notes would survive a payer audit.

We'll run a free documentation risk scan on a sample of your program's actual notes — scored against your payers' real medical-necessity criteria — and show you exactly where the revenue is leaking.