Month 1 Deliverable

RCM Positioning Framework

How to position Kipu RCM differently by archetype. What to say and why.

One Product, Six Conversations

Kipu RCM is the same platform regardless of who buys it. But the way you talk about it changes completely depending on who's across the table. A PE-backed COO doesn't care about "streamlined workflows." They care about EBITDA impact and margin expansion before the next board meeting. A nonprofit ED doesn't care about competitive displacement. They care about whether this helps them keep their SAMHSA grant.

This framework maps value language, objection handling, and competitive positioning to each ownership archetype identified in the ICP Validation Summary. The goal: every rep walks into every meeting with language that resonates with how that buyer defines value, not how we define features.

If you're reading this and thinking "I can just use the same pitch for everyone" — that's how deals stall in committee.

Core Platform Position Statement

Two positioning statements. One for the installed base. One for everyone else.

For Kipu EMR Customers

"Kipu RCM is the only revenue cycle solution purpose-built for behavioral health that operates from the same unified patient record as your clinical documentation. This means clinical decisions and billing outcomes are connected in real-time, not reconciled after the fact through manual processes, file transfers, or integration workarounds."

For Non-Kipu EMR Organizations

"Kipu is the only platform that unifies clinical documentation, patient engagement, and revenue cycle management in a single behavioral health operating system. Instead of managing three disconnected systems with three vendors and three sets of integrations, organizations can operate from one patient record that flows from admission through billing through alumni engagement."

Value Language by Ownership Archetype

What to lead with. What to avoid. Why it matters.

Tier 1

PE-Backed Multi-Site

Lead With:

"We reduce net days in A/R by an average of 18 days in the first 90 days. That's cash flow your board can see next quarter."

"Our denial management engine catches authorization gaps before they become write-offs. We're talking 12-15% denial rate reduction."

"You're running 4 facilities on 3 different billing processes. We standardize that without disrupting clinical ops."

Avoid:

"Easy to use" — they don't care about UX, they care about margin.

"We integrate with everything" — too vague. Name the specific systems.

"Long-term partnership" — PE thinks in 3-5 year hold periods. Show near-term impact.

Key metric: EBITDA impact per facility per quarter. Speak in dollars, not percentages.

Tier 1

Growth-Stage PHP/IOP (VC-Backed)

Lead With:

"You're adding sites faster than your billing team can scale. We make rev cycle a solved problem so you can focus on growth."

"Each new location doesn't need its own billing FTE. We centralize the process."

"Your payer mix is 70%+ commercial. That's exactly where our authorization engine delivers the most value."

Avoid:

"Enterprise-grade" — sounds expensive and slow to a growth-stage founder.

"Compliance first" — they know compliance matters, but don't lead with fear.

"Implementation takes 6-8 weeks" — reframe as "live in under 60 days."

Key metric: Revenue per site with/without Kipu RCM. Show the scaling math.

Tier 1

Large OTP Network

Lead With:

"42 CFR Part 8 documentation isn't optional. Our system builds compliance into the dispensing workflow so your staff doesn't have to think about it."

"Medicaid reimbursement timelines are brutal. We automate follow-up and reduce time-to-payment by 22 days on average."

"SAMHSA survey coming up? Our audit trail gives you documentation confidence your compliance director will appreciate."

Avoid:

"We handle all payer types" — they need Medicaid-specific depth.

"One platform for everything" — they need to hear dispensing and Part 8 specifics.

Generic ROI claims — OTP margins are thin. Be precise.

Key metric: Clean claim rate on Medicaid submissions. Audit readiness score.

Tier 2

Nonprofit BH Network

Lead With:

"Your grant reporting requires outcomes data tied to billing. We connect those two worlds so your team isn't doing double entry."

"Every dollar you recover in underbilled services goes back to your mission. We find the money you're already earning but not collecting."

"Your board wants to see financial sustainability metrics. We give you dashboards that tell that story."

Avoid:

"Revenue maximization" — nonprofits hear "aggressive billing" and recoil.

"Competitive advantage" — mission-driven orgs don't think in competitive terms.

Pressure tactics — grant cycles move on their own timeline. Respect it.

Key metric: Grant compliance accuracy. Recovered underbilled revenue as % of operating budget.

Tier 2

Owner-Operator Residential

Lead With:

"You built this facility. You shouldn't have to spend your evenings worrying about whether your biller submitted claims correctly."

"We've seen owner-operators recover $180K-$350K in annual revenue they didn't know they were leaving on the table."

"If you're thinking about succession planning or a future sale, clean rev cycle data increases your valuation."

Avoid:

"Scale your operations" — many owner-ops don't want to scale. They want control.

"Replace your billing staff" — those staff are often family or long-tenured employees.

Jargon-heavy pitches — speak plain. These buyers value directness.

Key metric: Annual revenue recovered. Peace-of-mind compliance score. Valuation readiness.

Tier 3

Hospital-Owned BH Division

Lead With:

"Your BH division's billing doesn't fit the acute care model. We give you a specialized rev cycle layer that works alongside your system EMR."

"IT doesn't want another system to manage. We've done this integration with Epic and Cerner environments before."

"Your BH division is probably the lowest-margin department. We change that math without requiring system-level approvals for every workflow change."

Avoid:

"Replace your current system" — IT will kill this immediately.

"Quick implementation" — hospital procurement doesn't move quick. Don't promise it.

Bypassing IT — they will find out. Loop them in early.

Key metric: BH division margin improvement. IT integration complexity score. Committee approval timeline.

OTP-Specific

OTP (Opioid Treatment Program)

Lead With:

"42 CFR Part 8 requirements, SAMHSA survey preparation, DEA documentation, dispensing records, callback tracking — your compliance burden is unlike any other behavioral health segment. We built for that."

"Your Medicaid-heavy payer mix means every clean claim matters. Our first-pass acceptance rate eliminates the rework loop that eats your staff's time."

"Dosing records, take-home schedules, and clinical notes have to align perfectly for billing to work. We enforce that alignment at the point of care."

Avoid:

"Generic behavioral health claims" — OTP operators know their world is different. Show that you know it too.

Treating OTP as an afterthought or a "module" bolted onto a residential platform.

"We handle all levels of care" — they need to hear methadone clinic specifics, not a generalist pitch.

Key metric: SAMHSA survey readiness score. Medicaid clean claim rate. DEA documentation compliance percentage.

Competitive Differentiation

Position against each competitor category with precision. Then plant the questions that create doubt.

Against Third-Party Billers

BHBilling, Integrity, etc.

"Third-party billers work from whatever data you send them. If clinical documentation is incomplete, inconsistent, or delayed, the biller can't fix that — they can only work with what they receive. Kipu RCM doesn't just bill claims; it surfaces documentation gaps before they become denials, enforces compliance requirements at the point of care, and provides the visibility to understand why revenue is being lost — not just that it's lost."

Questions to Plant:

  • "What's your current first-pass clean claim rate? Do you know, or does your biller know?"
  • "When a claim is denied, how long does it take you to find out why?"
  • "Can your biller tell you which clinician's documentation is causing the most denials?"

Against General Healthcare RCM

Waystar, Availity, AdvancedMD

"General healthcare RCM solutions weren't designed for the unique complexity of behavioral health billing. They don't understand concurrent review cycles, residential per diem billing, group therapy documentation requirements, or the distinction between ASAM levels of care."

Questions to Plant:

  • "How does your current RCM handle ASAM level-of-care transitions in the authorization workflow?"
  • "Can your system automatically flag when residential per diem billing exceeds the authorized number of days?"
  • "Does your platform know the difference between a group therapy note and an individual session for billing purposes?"

Against All-in-One Competitors

Sunwave, Alleva + billing

"The question isn't whether a vendor can check the RCM box. The question is how deeply that RCM functionality connects to clinical documentation and operational workflows."

Questions to Plant:

  • "Can their system tell you which specific documentation deficiency caused a denial — and route it back to the clinician for correction before resubmission?"
  • "What's their denial rate across their customer base? Will they share that data?"
  • "How many dedicated RCM engineers do they have vs. generalist developers?"

Clean Claim Rate: Kipu RCM vs Industry Average

Recommended Tension Level by Archetype

Competitive Displacement Messaging

When you're replacing an incumbent. Not trashing them — outpositioning them.

vs. Legacy Billing Companies

Their pitch: "We've been doing this for 20 years. We know behavioral health."

The reality: Most legacy billers are still running manual processes. They know BH payer rules but they're not catching denials in real-time, they're catching them 45 days later in a spreadsheet.

Your angle: "Experience matters. But experience plus automation is what actually moves your A/R. Ask them what their real-time denial interception rate is. If they can't answer that question, that's your answer."

Don't trash legacy billers. Reframe the conversation around speed and visibility.

vs. Large RCM Platforms (Waystar, Availity, etc.)

Their pitch: "Enterprise-scale, proven across thousands of providers."

The reality: Built for acute care. BH is an afterthought. Their "behavioral health module" is usually a skinned version of their med-surg workflow. Authorization requirements, ASAM levels, and clinical documentation standards for SUD/MH are fundamentally different.

Your angle: "They're great at med-surg. We're built for behavioral health. Ask them how they handle ASAM level-of-care transitions in their authorization workflow. If they hesitate, you know."

Position on depth, not breadth. BH specialization is the moat.

vs. In-House Billing Teams

Their pitch: "We control it. We know our patients. We trust our people."

The reality: In-house teams are often understaffed, under-trained on payer rule changes, and invisible to leadership until something breaks. The billing manager knows everything — and when they leave, so does the institutional knowledge.

Your angle: "Your billing team is great. But are they catching every authorization gap before it becomes a denial? Are they current on the Q3 payer policy changes? We augment your team, not replace them."

Never position as replacement for their people. Always augmentation.

vs. EHR-Bundled RCM (integrated billing modules)

Their pitch: "It's all in one system. No integration headaches."

The reality: Bundled RCM is a convenience feature, not a revenue optimization engine. It handles claim submission but rarely does proactive denial management, real-time eligibility verification, or authorization tracking with the depth that BH payers require.

Your angle: "All-in-one is great until your denial rate hits 18% and the only answer is 'submit a ticket.' We specialize in the part that actually recovers revenue."

Don't fight the all-in-one narrative. Fight on outcomes.

New Logo vs. Existing Business

Two completely different motions. Treat them that way.

New Logo: Competitive Displacement

Core Tension:

"You've built a billing process around tools that weren't designed for behavioral health. It works — until it doesn't. The question isn't whether you're collecting revenue. The question is how much you're leaving uncollected because your systems can't see what's falling through the cracks."

Discovery-Based Positioning:

  • "Walk me through what happens when a concurrent review is due and the clinician hasn't completed the documentation. How does your billing team find out?"
  • "When a claim is denied for medical necessity, how do you trace that back to the specific clinical documentation gap?"
  • "How many FTEs are dedicated to chasing authorization updates across your payer contracts?"

Teaching Insight (Challenger):

"Most behavioral health organizations we work with believe their denial rate is 8-12%. When we run a claims audit, the actual number is usually 15-22%. The gap isn't because billing is doing something wrong. It's because the systems aren't surfacing problems until 30-45 days after the revenue is already lost."

Existing Business: Platform Extension

Core Message:

"You're already generating the clinical data that drives billing accuracy. Right now, that data is flowing into one system and your billing process is running in another. We close that loop — same patient record, same platform, no file transfers, no reconciliation."

Audit-Based Positioning:

"Let us run a 30-day claims analysis against your current billing output. We'll show you exactly where documentation gaps are creating denials, where authorization timing is costing you revenue, and what the dollar impact is. No commitment required — just data."

Integration Advantage:

"Because you're already on Kipu EMR, there's no integration project. No data migration. No parallel systems. Your clinical documentation is already structured for RCM optimization — we just need to activate the billing intelligence layer."

Platform extension play. Lowest friction, highest velocity. 30-45 day close is realistic.

Objection Handling Matrix

The objections are predictable. The responses should be too.

Objection What They're Really Saying Response Framework Archetype Most Likely
"We already have a billing company." Switching cost feels high. Current vendor is "good enough." "What's your current denial rate? Most facilities we work with thought theirs was 8-10%. It's usually 15-22%. Can we run a free claims audit to see?" Owner-Operator, Nonprofit
"Our IT team won't approve another system." Integration anxiety. Past bad experiences. "We integrate via [specific API/HL7 method]. We've done this alongside Epic, Cerner, and legacy systems. Can we do a 30-minute technical review with your IT lead?" Hospital-Owned
"We can't afford this right now." Budget isn't allocated. ROI isn't clear enough to fight for it. "Most clients see the platform pay for itself within 90 days through denial recovery alone. What if we structured a pilot around your highest-denial payer?" Nonprofit, Owner-Operator
"We're in the middle of a transition." Organizational change. New leadership, M&A, EMR migration. "That's actually the best time to get rev cycle right. New leadership wants quick wins. What's the timeline on the transition?" PE-Backed, VC-Backed
"We need to see references." Not objection — buying signal. They're validating. "Absolutely. I'll connect you with [archetype-matched reference]. They had a similar setup — [X beds, Y payer mix]. Fair to schedule a follow-up after that call?" All
"What about HIPAA / compliance?" Risk aversion. Legal team involvement incoming. "We're SOC 2 Type II certified, BAA-ready on day one, and our compliance documentation is pre-built for your legal review. Can we send the security packet today?" Hospital-Owned, State/County
"We tried something like this before and it failed." Burned trust. High bar for proof. "Tell me what went wrong. Seriously — because if those same conditions exist, I'd rather tell you now than waste your time. What was the biggest failure point?" Owner-Operator, Nonprofit
"Our clinical staff won't adopt it." Change management fear. Past adoption failures. "Clinical adoption is the #1 predictor of RCM success. That's why we don't go live until your clinical team is trained and comfortable. We measure adoption, not just installation." All (especially multi-site)

Reframe Library

When the buyer frames the problem wrong, reframe it. Don't argue — redirect.

Executive Reframes

They Say: "Clinician burnout is our biggest problem."

Reframe to: EMR Friction

"Burnout is real. But when we talk to clinicians, a significant portion of their frustration isn't clinical — it's documentation. They're spending 2-3 hours per day on paperwork that doesn't feel connected to patient care. If the system made documentation feel like part of treatment instead of an administrative tax, how much of that burnout resolves itself?"

They Say: "Billing delays are killing our cash flow."

Reframe to: Clinical Documentation

"Billing delays are a symptom. The root cause is almost always documentation timing. When clinical notes aren't completed within 24 hours of service, the billing team can't submit claims on time. The fix isn't faster billing — it's closing the documentation loop before it creates a downstream bottleneck."

They Say: "We have a staffing shortage."

Reframe to: Workflow Inefficiency

"You may need more staff. But before you hire, ask this: how many hours per week does your current team spend on tasks that should be automated? Manual eligibility checks, authorization follow-ups, claim status inquiries — if you recovered 15-20 hours per week in automation, would you still need that additional FTE?"

Clinical Reframes

They Say: "Our clinicians resist technology."

Reframe to: Past Experience

"They don't resist technology. They resist bad technology. If every system they've used made their job harder, of course they're skeptical. The question is: what would a system have to do differently for them to actually want to use it? That's the conversation we should be having with your clinical leads."

They Say: "Compliance is billing's problem."

Reframe to: Shared Accountability

"Compliance starts at the point of care. When a clinician documents a group therapy session without meeting the minimum participant threshold, that's a compliance gap that becomes a denied claim 45 days later. Billing can't fix what clinical didn't document. The only way to solve this is to connect both sides of the equation."

They Say: "We don't have time for training."

Reframe to: Time Investment vs. Time Tax

"You're paying a time tax every day on workarounds, manual processes, and rework. Training is a one-time investment that eliminates a recurring cost. If training takes 8 hours but saves 3 hours per week, you've broken even in less than 3 weeks. After that, it's pure time recovery."

Operational Reframes

They Say: "We passed our last audit."

Reframe to: Audit Is Backward-Looking

"Passing an audit means you met minimum requirements at a point in time. It doesn't mean your documentation would withstand a payer-specific review, a RAC audit, or a state licensing survey next month. Audits look backward. Compliance systems look forward. The question is: are you audit-ready right now, today, for any payer?"

They Say: "Our denial rate is industry average."

Reframe to: Average Is Expensive

"The industry average denial rate in behavioral health is 15-20%. On $10M in annual revenue, that's $1.5-$2M in claims that need rework, appeal, or write-off. 'Average' isn't a benchmark to aspire to — it's a measure of how much money the industry collectively leaves on the table. What would it mean for your organization to be at 5-8% instead?"

They Say: "We've already invested in our current system."

Reframe to: Sunk Cost vs. Ongoing Cost

"The money you've spent is spent. The question is whether you're continuing to pay an ongoing cost — in staff time, in denied claims, in manual workarounds — to maintain a system that isn't delivering the outcomes you need. Sunk cost protects the past. Your decision should protect the future."

Value Quantification Framework

Make the ROI tangible. Every conversation should move toward a number.

Revenue Recovery

The money they're currently losing that Kipu RCM can recapture.

Quantification Questions:

  • "What's your current denial rate? (Industry avg: 15-20%)"
  • "What percentage of denied claims are successfully appealed?"
  • "What's your average time from service to claim submission?"
  • "How many claims per month are written off without appeal?"
  • "What's your net collection rate? (Target: 95%+)"

Calculate: (Denial Rate Reduction x Annual Revenue) + (Appeal Success Rate Improvement x Denied Claims Value)

Efficiency Gains

The staff time and operational cost that Kipu RCM eliminates.

Quantification Questions:

  • "How many FTEs are dedicated to billing and claims follow-up?"
  • "How many hours per week does clinical staff spend on documentation rework?"
  • "What's the average time to post a payment after receipt?"
  • "How many manual eligibility checks does your team run per day?"
  • "What's the cost of your current billing vendor or in-house billing team?"

Calculate: (Hours Saved x Blended Hourly Rate) + (Eliminated Vendor Costs) + (Reduced FTE Requirements)

Risk Mitigation

The compliance exposure and audit risk that Kipu RCM reduces.

Quantification Questions:

  • "When was your last payer audit? What was the outcome?"
  • "Have you received any recoupment demands in the past 12 months?"
  • "How confident are you in your documentation for a RAC audit?"
  • "What's your current process for tracking authorization expirations?"
  • "How do you monitor compliance with state-specific billing requirements?"

Calculate: (Historical Recoupment Costs) + (Audit Preparation Costs) + (Compliance Penalty Risk)

Five Messaging Principles

These apply regardless of archetype.

1. Lead with Pain, Not Features

Nobody cares about your denial management engine until they feel the pain of a 19% denial rate. Start with their problem. The feature is the resolution, not the opening.

2. Speak Their Financial Language

PE speaks EBITDA. Nonprofits speak grant compliance. Owner-ops speak cash in the bank. Hospitals speak margin contribution. Use their words, not yours.

3. Name the Specific Number

"We improve outcomes" is meaningless. "We reduce net days in A/R from 52 to 34 in the first quarter" is a conversation starter. Be specific or be ignored.

4. Acknowledge the Switching Cost

Don't pretend switching is painless. It isn't. Acknowledge the cost, then show why the cost of staying is higher. Honesty builds more trust than a smooth pitch.

5. Match Urgency to Ownership

PE-backed: create urgency around board timelines. Nonprofit: align with grant cycles. Owner-op: don't manufacture urgency. Hospital: map to fiscal year budgets. The clock is different for everyone.

Bonus: Shut Up After the Ask

After you propose next steps, stop talking. The silence is uncomfortable for you, not for them. Let them process. The best closers know when to stop selling.

Positioning Quick Reference

One-glance cheat sheet. Print this. Tape it to your monitor.

Archetype Lead With Avoid Tension Level Primary Value Language
PE-Backed Multi-Site EBITDA impact, A/R reduction, standardization across sites "Easy to use," vague integration claims, "long-term partnership" 9/10 — High Margin expansion, cash flow acceleration, portfolio value
VC-Backed Growth Scalability, centralized billing, commercial payer optimization "Enterprise-grade," compliance-first messaging, long timelines 7/10 — Medium-High Revenue per site, growth enablement, operational leverage
Owner-Operator Revenue recovery, peace of mind, valuation readiness "Scale your operations," replacing staff, jargon 3/10 — Low Personal control, financial clarity, succession planning
Nonprofit Grant compliance, recovered underbilled revenue, mission alignment "Revenue maximization," competitive language, pressure tactics 2/10 — Low Mission sustainability, stewardship, board-ready metrics
Hospital-Owned BH-specific layer alongside system EMR, margin improvement "Replace your system," quick implementation, bypassing IT 2/10 — Low Division margin contribution, IT compatibility, committee alignment
OTP 42 CFR Part 8, SAMHSA readiness, Medicaid optimization, dispensing compliance Generic BH claims, treating OTP as afterthought, generalist pitch 5/10 — Medium Regulatory compliance, audit readiness, Medicaid clean claim rate