How a behavioral health EMR company with no native billing capability launched a full revenue cycle management platform in 15 months — and drove 250% revenue growth in the process.
The Situation
Alleva served day treatment and residential behavioral health organizations with a modern, purpose-built EMR. But there was a significant gap in the platform: no native billing capability. Customers were managing their revenue cycle through disconnected third-party tools — creating broken workflows, duplicate data entry, compliance risk, and lost revenue visibility.
The pressure was coming from every direction. Customers were actively asking for integrated billing. Competitors already offered native RCM and Alleva was losing deals because of the gap. The business case was undeniable: build a full RCM platform or continue losing ground in a market that was consolidating fast.
The assignment: Leadership brought me in to own the full RCM product build from concept through launch — including vendor selection, contract negotiation, product architecture, agile delivery, and go-to-market.
The Challenge
Building an RCM platform from scratch inside a behavioral health EMR meant navigating complexity that goes well beyond typical product development. Every decision had downstream compliance, payer, and operational implications.
The Approach
With a compressed timeline and no existing foundation to build on, the approach required running multiple workstreams simultaneously rather than sequentially. Discovery informed architecture while vendor negotiations ran alongside development.
Customer interviews with billing staff, competitor teardowns, payer workflow mapping, vendor landscape analysis, compliance research
MVP scoping, integration sequencing, dual-product design (standalone + integrated), vendor contract negotiation, compliance framework
Agile delivery across all modules with cross-functional offshore/onshore team; iterative testing with billing staff throughout
Phased rollout, GTM enablement, billing staff onboarding, post-launch optimization and feedback loops
The platform was architected as six integrated modules and seamless workflow:
Electronic Claims
Professional (837P) and institutional (837I) claim submission with payer-specific rules and compliance validation built in.
Payment Posting
Apply payments in many forms and in many places for optimal workflow. Included auto post to oldest balance and clear visibility to unapplied funds.
Claim Control
Ability to group per diem services onto selected claims, with the ability to order services on claims for precise billing control.
Integrated Payments & Plans
Credit card processing and payment plan management via Nexio integration, eliminating the need for a separate payment terminal or tool.
Customizable Statements
Patient-facing statement generation with configurable filters to match each practice's statement data and cadence.
Settings & Configuration
Practice-level RCM configuration supporting payer rules, fee schedules, provider settings, and billing preferences.
Vendor partnerships were negotiated and delivered concurrently with product build — not as a pre-requisite. This required managing legal, technical, and product workstreams simultaneously with two key partners:
The Outcomes
The Alleva RCM platform launched within the target window and delivered measurable impact across revenue, product positioning, and customer retention.
Reflection
“The hardest part of building an RCM platform from scratch is not the technology — it is building the right knowledge fast enough to make good decisions under pressure. Healthcare billing has layers of regulatory, payer, and operational complexity that you cannot shortcut. The only way through is deep discovery, honest scoping, and a team that trusts each other to raise problems early. That is what made this work.”
This project reinforced that the most valuable thing a product manager can do in a 0 to 1 build is ruthlessly protect the MVP scope while keeping the long-term architecture flexible. Every feature we deferred in the first release created room to ship faster — and every feature we shipped was grounded in what billing staff actually needed to do their jobs.