DDH Consulting collects and processes public healthcare data to surface revenue opportunities at the provider level — program enrollment gaps, reimbursement discrepancies, and unclaimed federal and state program revenue. We build the data infrastructure and FP&A reporting systems that give healthcare finance leadership a clear, organized view of performance.
DDH Consulting collects and processes public healthcare data to deliver revenue performance intelligence to physician groups, management services organizations, and healthcare finance leaders. We build production systems and maintain them on an ongoing basis. Our deliverables are infrastructure and intelligence, not advisory reports — clients own their reporting layer.
We specialize in Healthcare Revenue Intelligence — identifying gaps and reimbursement discrepancies — and Financial Data Architecture & FP&A Reporting — building the infrastructure that gives finance teams a clear view of their performance.
From the data infrastructure to the public-data intelligence that powers it, and the maintenance that keeps it current.
We design and build end-to-end data infrastructure — automated pipelines, cloud data warehouses, and semantic data models that connect your operational and financial data to our healthcare intelligence layer, producing a unified view of revenue performance.
You own it: Every system is production-grade, documented, and owned by your organization at the conclusion of the engagement.
We collect, process, and organize public federal and state healthcare program data into a structured intelligence layer that identifies revenue gaps at the provider level — placing your organization's performance in the context of program benchmarks, enrollment status, and reimbursement standards.
Always current: The intelligence layer is refreshed monthly as program lists and federal data sources update.
We build the reporting infrastructure healthcare finance teams use daily — semantic models, executive dashboards, revenue cycle analytics, and payer performance reporting. Built with enterprise architectural rigor: pre-calculated dimensions, fact tables, and measures your team can analyze without technical support for every report.
Self-serve: Finance teams analyze on demand — no ticket required for every question.
Client reporting systems require ongoing maintenance as data sources evolve, new program data becomes available, and organizational needs change. We support client-specific systems with pipeline monitoring, dashboard updates, schema changes, and integration of new data sources.
A standing function: A continuous intelligence partner — not a one-time implementation.
A clear path from raw public healthcare data to intelligence your finance team uses every day.
We collect and process federal and state healthcare program data into a structured intelligence layer, refreshed monthly as official sources update.
We build the pipelines and semantic models that place your organization's performance in the context of program eligibility, enrollment, and reimbursement standards.
You receive a production reporting layer your finance team owns and operates — surfacing revenue gaps and financial performance on demand.
DDH maintains an intelligence layer built entirely from public federal and state healthcare data, refreshed monthly as program lists and data sources update. We currently track five categories of revenue opportunity at the provider level — identifying where program eligibility, enrollment status, and reimbursement standards point to gaps worth investigating.
Florida law requires Medicaid managed care plans to reimburse MPIP-qualified primary care physicians at Medicare-equivalent rates. When a plan fails to recognize a provider's eligibility, every Medicaid claim is underpaid — often undetected for extended periods. We cross-reference provider enrollment against AHCA qualified-provider lists across all 20 Florida managed care plans, monthly.
CMS applies automatic Medicare Part B payment adjustments — up to a 9% penalty — based on annual MIPS performance, applied two years after the performance period. We identify providers facing negative adjustments, quantify the exposure against their billing volume, and flag those eligible but not participating in MIPS or ACO arrangements.
Three care management codes effective January 2025 (G0556, G0557, G0558) provide monthly reimbursement for primary care practices managing patients with chronic conditions. Most practices have not added them to billing workflows despite qualifying Medicare panels. We identify utilization patterns consistent with eligibility and low or absent APCM activity.
Chronic care management (99490, 99491, 99487) and transition care management (99495, 99496) codes provide reimbursement for ongoing management of chronic conditions and post-discharge coordination. These codes are consistently underutilized relative to eligible populations. We identify practices with Medicare populations consistent with significant eligibility and low utilization.
The 340B Drug Pricing Program allows qualifying healthcare organizations to purchase outpatient drugs at significantly reduced prices. Organizations that meet eligibility criteria but are not enrolled — or are not fully utilizing the program — may be incurring unnecessary drug expenditures. We identify organizations that appear to meet eligibility based on HRSA data.
Our intelligence layer expands as new federal and state programs and data sources become available. Categories are tailored to each organization's payer mix, specialties, and patient population during the assessment phase.
DDH identifies documented administrative and eligibility gaps using public data. We do not guarantee recovery amounts; opportunity varies by payer mix, Medicaid and Medicare volume, and patient population.
A specialty pharmacy engaged DDH Consulting to build data infrastructure connecting accounts receivable, claims processing, and revenue cycle data. The resulting system surfaced $340,000 in previously unidentified revenue discrepancies and reduced the finance team's monthly reporting time by 87%.
Client names are kept confidential. Additional case studies available upon request.
Organizations & focus
We structure engagements in three clearly defined phases. Engagement investment is scoped individually and discussed during a discovery conversation.
A focused analysis of your provider portfolio against DDH's public intelligence data — MPIP enrollment across all managed care plans, MIPS participation and performance, APCM billing patterns, and other relevant program indicators. Delivered as a structured findings report with provider-level detail and a prioritized opportunity summary.
Design and build of client-specific infrastructure — connecting your billing and financial data to DDH's intelligence layer, building a semantic model aligned to your reporting needs, and delivering a production dashboard your finance team uses daily. You own the infrastructure at conclusion.
A monthly intelligence retainer covering public data refresh and program list updates, plus a separate maintenance function for client-specific system support, dashboard evolution, and integration of new data sources as your organization grows.
Tell us what you're working to solve. A portfolio assessment requires only your NPI numbers to begin, and we respond to every inquiry within one business day.
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For urgent needs, email contact@ddhbiconsulting.com directly.