5Q Health helps rural and safety-net organizations, and the counsel who work with them, govern the automated systems that now decide who gets covered, what gets approved, and how claims are paid. We look at how current automated systems are trained to practice, and at what must be documented to answer their decisions.
Our clinical roots are in complex rehabilitation technology and assistive technology. The method applies wherever an automated system makes a decision about a person’s care: prior authorization, Medicaid eligibility, claims payment, and the adoption, purchase, and use of medical devices.
New · September 28, 2026WISeR at Nine Months: What the Records Show →
I’m Tabatha James. For more than a decade I worked alongside rural and under-resourced Medicaid patients in Illinois and Tennessee, getting people the wheelchairs, equipment, and care they needed. Over those years, automated denials delayed or blocked more and more of that care. Now I help rural health organizations govern the AI that makes those decisions.
AIGP · OTR/L · RESNA ATP/SMS · Master of Legal Studies (MLS), Health Law and Policy, Wake Forest Law (expected December 2027)More about Tabatha →
Start wherever your exposure is.
The complex claim is the path of least resistance to deny.
See diagnostic, build & advisory packages →The operational layer auditors and regulators actually examine.
See AI Governance Operations →Independent, confidence-scored regulatory intelligence.
Explore the tools & analysis →“5Q” comes from the Five Whys, the root-cause method healthcare quality teams use to trace a problem past its symptoms.
Data governance asks four questions of every system: Is it legal? Is it ethical? Is it a good idea? How do we know, and who decides? The fifth comes from occupational practice: who does this help participate, and who does it leave out?
Vetting AI tools before you adopt them, and keeping your data and reporting defensible so your funding stays protected.
Find where automated review threatens your revenue, then build the appeals and documentation readiness to answer it.
An AI inventory, risk tiering, and audit-ready evidence aligned to NIST, ISO/IEC 42001, and HIPAA.
Free and private: everything runs in your browser.
Model your North Carolina Medicaid equipment revenue exposure when the rate floor expires in 2029.
Run the calculatorA plain-language checklist for families facing the January 2027 Medicaid work rules, with an hour log and free help.
Open Coverage KeeperA self-assessment against Joint Commission’s Responsible Use of AI certification. Joint Commission accreditation is not required.
Open the Scorecard overviewSeven plain questions for leaders considering an AI tool, with a readiness result and a to-do list.
Start the checkTracks North Carolina’s funded data and AI programs in public benefits, verified against the enacted budget.
Open GDAC WatchVersioned, dated, and confidence-rated, to the same standard as client work.
Read the nine-month updateEarlier in the series: The WISeR Model at Six Months →
Also in the library: Why Software Vendors Can’t Audit Their Own AI →
From the Privacy Series: WOPR Is a Privacy Law →
North Carolina: The 2027 work requirement and medical frailty → · RHTP Governance Partnership →
Primary sources: The Reading Room →
Tabatha James founded 5Q Health after more than a decade of front-line, client-centered clinical care, trained in occupational therapy, with rural and under-resourced Medicaid patients in Illinois and Tennessee. From 2019 she specialized in complex rehab technology, first evaluating people for wheelchairs and seating and later working on the supplier side, during the years when automated prior authorization and denials expanded.
The lens is occupational justice, a principle from occupational therapy: everyone has a right to take part in the everyday activities that give life meaning — working, caregiving, getting around, living at home. When an automated system decides coverage, payment, or whether a person gets the medical device or assistive technology they need, that right can be lost at scale. 5Q Health helps rural and safety-net organizations govern those systems, working alongside their counsel.
5Q Health is based in Henderson County, North Carolina, where Tabatha grew up and has returned home.
How we work. 5Q Health aims to be nonpartisan and useful to the largest number of people, while paying attention to smaller populations that research often misses. It serves people affected by automated decisions and the organizations responsible for them. Opinions follow the evidence and do not depend on who retains us or how a matter ends. Analyses are dated, versioned, and rated HIGH, MED, LOW, or FLAG for confidence, and each is checked in three passes. 5Q Health is not a law firm and does not give legal advice; it works alongside your counsel. How this content is made.
A thirty-minute scoping conversation is free. 5Q Health provides analysis and governance advisory, not legal advice, and works alongside your counsel.
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