For UR Directors & Revenue Cycle Managers in Behavioral Health
Faster authorizations, fewer denials — on the Kipu or BestNotes EMR you already run.
CriteriaIQ RCM gives behavioral health billing companies and treatment facilities one platform to manage utilization review, track authorizations, and fight denials — no migration, no chart re-entry. It layers on top of your existing Kipu or BestNotes EMR.
One platform connects your utilization review, eligibility verification, billing, and denial management workflows. Built specifically for how behavioral health revenue cycle actually works.
AI-assisted medical necessity analysis against ASAM, MCG, and InterQual criteria
Automated review reminders before authorization windows close
Structured denial tracking with appeal deadline management
Client portal so facilities see their own auth status in real time
Webhook API to connect with your existing billing systems
Kipu EMR integration — sync patients directly, no manual entry
Behavioral health practices lose an estimated 10 to 20% of potential revenue to preventable billing mistakes and claim denials. For a facility billing $2 million a year, that is $200,000 to $400,000 walking out the door.Estimate from PIMSY, Behavioral Health Revenue Cycle Management (2026). Dollar figures are an example calculation.
See it in Action
The platform in action.
Real screenshots of the CriteriaIQ RCM platform managing authorizations, tracking denials, and connecting with Kipu EMR.
Never miss another authorization deadline.
Priority alerts flag cases that need immediate attention. Visual countdown timers show exactly how many days remain on each authorization.
Structured denial workflow with CARC/RARC tracking, appeal deadline management, and specialist assignments. Track overturn rates by payor and facility.
→ 13 denial categories with code tracking
→ Appeal deadline countdown timers
→ Overturn rate analytics
No Migration Required
Keep your Kipu or BestNotes EMR — no migration, no data move, no cash-flow gap. CriteriaIQ RCM layers on top of the chart your team already uses via API, independent of and not affiliated with Kipu.
✓ Syncs with Kipu EMR✓ Syncs with BestNotes
Built and supported by Steven Cavan, in behavioral health utilization review since 2012 — not a support ticket queue. Read the story →
Built for UR teams and billing companies running authorization and denial workflows across a facility or multiple sites — not a fit for a solo private-practice therapist. Kipu and BestNotes sync out of the box; other EMRs with an API can typically be connected through a custom integration on request.
Platform Features
Everything your UR team needs, nothing they don't.
Built by utilization review specialists. Three things you won't find bundled together anywhere else — plus everything else you'd expect.
Why teams switch
⚕
Criteria Analyzer
AI-powered analysis against ASAM 4th Edition, Milliman MCG, and InterQual BH criteria. Generates phone review scripts and appeal letters.
Why teams switch
🔗
Kipu or BestNotes EMR Sync
Connect with your existing API credentials. Active patients sync directly into authorization records — no migration, no duplicate data entry.
Why teams switch
💳
Billing & AR, Built In
Track claim status, submission dates, payment, and aging across 0–90+ day buckets — in the same place as UR and denials, not a separate tool.
Also included
📋
Authorizations and deadlines
Every authorization in one place, with concurrent review dates, P2P tracking, and reminders before a review window closes. Eligibility checks are linked to the same record.
📊
Denials and reporting
See where denials and delays happen by payor, facility, and specialist. Alerts flag expiring authorizations and priority cases before revenue is at risk.
👁
Team and client access
Give facilities a read only login to check their own patients' authorization status, so they stop calling you for updates. Enterprise can run it under your own brand.
See all features
Never miss an authorization deadline Every authorization in one place. Concurrent review scheduling, P2P tracking, appeal management, and automated reminders.
Catch coverage gaps before they become denials Document eligibility checks with coverage dates, deductibles, OOP maximums, and network status — all linked to the authorization record.
Stop the where-is-my-auth phone calls Give facilities a read-only login to see their own patients' authorization status. No more calls asking for updates.
See where denials and delays are actually happening Authorization approval rates, denial trends, AR aging, and specialist performance — filterable by date, facility, and payor.
Get warned before revenue is at risk In-app and email alerts for review due dates, expiring authorizations, and priority cases — before revenue is at risk.
Run it under your own brand Resell CriteriaIQ RCM under your own brand. Custom logo, colors, and domain. Your platform, your clients.
Chrome extension for Kipu EMR. Analyzes patient charts against ASAM, MCG, and InterQual criteria in seconds. Generates phone scripts and appeal letters.
No. CriteriaIQ RCM connects to your existing Kipu or BestNotes EMR via API sync — it's a layer on top of your current system, not a replacement. Patient data syncs in automatically; there's no chart migration and no disruption to clinical workflows already running in your EMR.
What happens to my data if I cancel?
Per our Business Associate Agreement, all PHI is returned or destroyed within 30 days of termination, with written confirmation available on request. You can cancel a monthly plan anytime through your account settings, with access continuing through the end of the current billing period.
Who supports me?
Direct support from the CriteriaIQ team at support@criteriaiq.com — built and supported by someone who's worked utilization review since 2012, not a ticket queue. Enterprise and White-Label plans include priority support and a dedicated support line.
What happens if the company grows or changes hands?
Your data is portable on demand under the BAA, with nightly automated backups and full PHI return or destruction within 30 days of termination. The platform runs on redundant cloud infrastructure, and API webhooks mean your workflows are never locked to a single person's screen. Enterprise and White-Label plans carry a same-business-day support response commitment.
Is CriteriaIQ RCM right for me?
It's built for UR teams and billing companies running authorization, denial, and billing workflows across a facility or multiple sites. It's not built for a solo private-practice therapist tracking a handful of clients. Kipu and BestNotes sync out of the box; if you're on a different EMR with an API, we can usually build a custom integration on request.
How do you compare to Kipu, Ritten, or Behave Health?
Not a trust badge graphic — here's exactly what's signed, backed up, and supported today.
In place before you sync
📄
Business Associate Agreement
A signed BAA is in place before any PHI syncs from your EMR. Per its terms, all PHI is returned or destroyed within 30 days of termination, with written confirmation available on request. Read the BAA →
Your data, your control
💾
Portable by Design
Nightly automated backups and redundant cloud infrastructure. Data is portable on demand under the BAA — your workflows are never locked to a single person's screen.
Direct, not a ticket queue
🩺
Support From Someone Who's Done This
Built and supported by Steven Cavan, in behavioral health utilization review since 2012. Enterprise and White-Label plans include a same-business-day support response commitment. Read the story →
🔗 Integrates with Kipu EMR — API Sync VerifiedDirect API sync, independent of and not affiliated with Kipu.
Pricing
Straightforward pricing. No surprises.
All plans include unlimited authorizations, document storage, and email notifications. Annual billing saves 15%.
Every competitor makes you request a demo. We publish our prices — start today, no sales call.
Try it free for 14 days with no credit card. If it isn't a fit, the trial simply ends on day 14 and nothing is charged. Your team keeps charting in Kipu or BestNotes the whole time, so there is nothing to migrate and nothing to undo.
Who you're buying from
Built by a UR professional, not a software company.
Steven Cavan has worked in behavioral health since 2004 and in utilization review full time since 2012. He built CriteriaIQ RCM after years of watching facilities lose authorizations to documentation gaps and missed review dates. CriteriaIQ is new, so during your trial you work with Steven directly: setup, questions, and feedback go straight to him.
✓ 20+ years in behavioral health✓ 12+ years in utilization review✓ BA, Applied Clinical Psychology✓ MS, Information Assurance and Cybersecurity
"The goal has always been simple: make the documentation reflect the clinical reality."
Design partner program · open to the first 5 facilities
CriteriaIQ RCM is new. Help shape it.
We're looking for 5 behavioral health facilities or billing companies to use CriteriaIQ RCM in their real UR workflow and tell us what works and what doesn't.
What you get
✓ Today's list price, locked for 2 years
✓ Free setup help from Steven: connecting Kipu or BestNotes and entering your first authorizations
✓ Your feature requests go to the front of the line
✓ Steven's direct phone and email
What we ask
→ A 30 minute feedback call once a month
→ After 60 days, we'll ask for an honest review on G2. Your pricing doesn't depend on it.
→ If you're happy after 60 days, permission to quote you. No obligation.
Add-ons: +$99/mo per additional specialist · +$99/mo per additional facility · +$299/mo Criteria Analyzer (standalone)
On a different EMR? Kipu and BestNotes sync out of the box — most other behavioral health EMRs with an API can be connected through a custom integration on request. Ask us about yours →
UR Starter
Professional UR teams up to 5
Enterprise Multi-facility operators
White-Label
Specialists
Up to 2
Up to 5
Unlimited
Unlimited
Facilities
1
3
Unlimited
Unlimited
Authorization tracking
✓
✓
✓
✓
Denial management
✓
✓
✓
✓
Client portal
—
✓
✓
✓
Kipu / BestNotes EMR sync
—
✓
✓
✓
API webhooks
—
✓
✓
✓
Analytics dashboard
—
✓
✓
✓
Criteria Analyzer included
—
—
✓
✓
White-label / resell
—
—
—
✓
Ready to stop losing revenue?
See CriteriaIQ RCM in action.
14-day free trial. No credit card required. Connects to your existing Kipu or BestNotes account.
