Reimbursement defense · AI governance · Regulatory intelligence

Healthcare now runs through an automated gate.

Prior authorization, prepayment review, and payment-integrity analytics increasingly decide whether a clean claim is paid — and the complex claim is the path of least resistance to deny. 5Q Health works the seam where claims, algorithms, and regulations meet: protecting reimbursement for the organizations navigating automated adjudication, building the governance for the ones deploying it, and tracking the infrastructure for everyone exposed to it.

Accountable AI. Human Healthcare. Governance as Infrastructure.
Led by Tabatha James — AIGP · OTR · RESNA ATP/SMS. Over a decade of front-line clinical care in rural, underserved communities, then supplier-side practice in the FDA Class II medical device sector — both sides of the prior-authorization table, through the years automated denials ramped up (2019–2025). Now paired with an AI-governance, privacy, and health law & policy lens (MS, Wake Forest Law, in progress).
Full background →
Start where you stand
Suppliers & providersThe denials are automated. Your response can be governed. Payers, systems & vendorsBuild the governance layer auditors actually examine. CounselClinical + governance analysis for algorithmic-denial matters. Clinicians & educatorsLearn what the algorithm reads in your documentation. Patients & familiesKeep the coverage you still qualify for. Free.
What we do

Three ways 5Q works.

The practice converges where claims, algorithms, and regulations meet — from the organizations navigating automated adjudication to the ones building it. Start wherever your exposure is.

For suppliers & providers

Protect reimbursement

The complex claim is the path of least resistance to deny.

  • Denial, recoupment & prior-auth exposure diagnostics
  • Appeals & medical-necessity readiness, with staff training
  • Prepayment-review positioning & documentation posture
See diagnostic, build & advisory packages →
For payers, health systems & AI vendors

Build & operate AI governance

The operational layer auditors and regulators actually examine.

  • AI use-case inventory & registry build
  • Risk-tiering aligned to NIST AI RMF & ISO/IEC 42001
  • Audit-ready evidence mapped to HIPAA, CMS, ONC/HTI & the state and federal AI requirements that apply to you
See AI Governance Operations →
For everyone exposed to algorithmic adjudication

Track the landscape

Independent, confidence-scored regulatory intelligence.

  • GDAC Watch — North Carolina's adjudication infrastructure, tracked (launching on enactment)
  • The WISeR analysis library — versioned, dated, on the record
  • Free working tools for both sides of the gate
Explore the tools & analysis →
Run an FQHC, Critical Access Hospital, rural clinic, or a Hub that supports them? There's a dedicated path — the RHTP Governance Partnership, the AI-and-data governance layer that extends the reach of what your HCCN already does: vetting the AI tools you adopt, and keeping your data and reporting defensible so your funding stays protected.
The name is the method

Five whys, one root cause.

"5Q" is the Five Whys — the root-cause discipline that traces a problem past its symptoms. Here is the chain most suppliers and rural providers are living right now.

1

Why was the claim denied?

The documentation didn't satisfy an automated first-pass review — even though the care was medically necessary and the record was complete by any human standard.

2

Why did an automation review it?

Payers now run prior authorization and payment integrity through algorithms — from Medicare's AI-assisted prior-authorization pilots to state Medicaid payment-integrity analytics.

Federal WISeR model · State analytics programs
3

Why does it hit complex claims hardest?

Individualized medical necessity doesn't map cleanly to automated rule sets. Complex rehab, high-documentation DME, and rural safety-net claims are the worst-case profile for algorithmic adjudication — where a model tuned to reduce "error" finds its easiest denials.

4

Why doesn't anyone catch it?

Because the models often carry no enumerated governance — no bias audit, no transparency requirement, no documented human-review or appeals standard. The gate is real; the regulatory keys to the gate are fragmented, or missing altogether.

5

Why 5Q?

Because 5Q governance holds four things at once: accountability, claim fluency, algorithmic scrutiny, and regulatory awareness. Operationalizing that intersection is designed to support responsible AI use, build stakeholder trust, and reduce the financial exposure that automated decisions create — for individuals and enterprises alike.

Root cause

Governance isn't compliance overhead. It's the infrastructure that decides whether your good work survives the algorithm — and the review.

Services

Fixed-fee. Scoped in writing. Confidence-scored.

Every engagement is delivered under a three-pass validation discipline: draft against primary sources, adversarial audit with confidence ratings on every finding, final synthesis with documented limitations. No open-ended hourly billing.

Tier 1 · Diagnostic · Two weeks

Denial Exposure Scan

$3,500 fixed

A rapid diagnostic of where automated adjudication threatens your revenue — sized so a compliance officer can approve it without a committee.

  • Denial, recoupment, and prior-auth pattern review across payers
  • Documentation posture vs. automated first-pass review
  • Payer-AI exposure map for your book of business
  • Confidence-scored findings memo + 90-day roadmap
Tier 2 · Project · Four to eight weeks

Readiness Build

from $9,500

A scoped build of the capability your scan — or your denial trend — says you need.

  • Appeals & medical-necessity readiness, with staff training
  • Payer-AI governance review and escalation playbook
  • Prepayment-review readiness & exemption positioning
  • Clinical-AI due diligence and equity review
Tier 3 · Retainer · Three-month minimum

Standing Advisory

$2,750 / month

The regulatory landscape, watched for you — against your specific payers and product lines.

  • Monthly tailored regulatory brief (coverage, MAC, AI & analytics)
  • Four hours of on-call advisory each month
  • Quarterly denial-trend and documentation review
Enterprise · Payers, health systems & AI vendors

AI Governance Operations

For organizations standing up or maturing an enterprise AI governance function — the operational layer auditors and regulators actually examine. AI use-case inventory and registry build; risk-tiering intake and assessment workflows aligned to NIST AI RMF and ISO/IEC 42001; mitigation and gap-closure coordination with tracked close-out; and audit-ready documentation and evidence packages mapped to HIPAA, CMS, ONC/HTI, Section 1557 nondiscrimination, and the state and federal AI requirements applicable to each use case.

Program build from $18,000 · Fractional governance operations from $4,500/mo · Start a scoping conversation
For FQHCs, Critical Access Hospitals & rural health Hubs

RHTP Governance Partnership

The AI-and-data governance layer that extends the reach of what HCCNs already do. For rural safety-net organizations adopting AI without an internal governance function — and the Hubs reporting to a CMS standard. 5Q stands up the local tool-vetting process, the governance architecture those tools depend on (shared definitions, decision rights, privacy including 42 CFR Part 2, and equity checks for rural and tribal patients), and the reporting readiness that keeps funding defensible — built to stay consistent across regions, so one organization's readiness becomes a portable template rather than an island.

Two tracks — direct, or through an HCCN / Hub partnership · Pass-through & grant funded · Start a scoping conversation

Scan fees are credited toward a Readiness Build contracted within 60 days. Request the full rate card →

Working tools

Built for both sides of the gate.

Free, working instruments — because governance that only protects the entity has failed the 5Q test. One lane for the organizations navigating automated adjudication, one for the people it adjudicates.

For suppliers & providers

The 2029 Convergence Calculator

North Carolina's DME rate-floor expiry, the PHP rebid, and cost-containment machinery converge in 2029. Model your organization's exposure window and see what the timeline means for your book of business.

Run the calculator
For families & beneficiaries

Coverage Keeper

Automated reviews mean more paperwork, more deadlines, and more ways to lose coverage you still qualify for. A plain-language companion for keeping benefits on track and contesting decisions that got it wrong.

Open Coverage Keeper
For organizations deploying AI

RUAIH Readiness Scorecard

Joint Commission’s Responsible Use of AI certification arrived in June — and accreditation isn’t a prerequisite. A 34-item, evidence-scored self-assessment of where you stand across the five certification areas, with a dual-protection cap that keeps patient safeguards non-negotiable.

Open the Scorecard overview
For rural health leaders

Rural-AI Deployment Evaluator

AI is not gap-neutral: the same tool can extend rural care or quietly hollow it out. Score a specific deployment across three forms of leverage and three preconditions, and read whether it closes the gap — or widens it.

Score a deployment
For everyone watching the infrastructure

GDAC Watch

A public dashboard tracking North Carolina's algorithmic adjudication infrastructure — the analytics provisions, the agencies operating them, and the governance controls present or absent for each.

Launching upon enactment of the state budget
Analysis library

Versioned findings, on the record.

The WISeR Model at Six Months
Medicare's AI-assisted prior-authorization pilot, mapped against a confidence-scored governance framework — the contingent-fee incentive structure, the GAO determination that the model notice is a rule, the first contractor corrective action plan, and what the enforcement record signals for every payer that follows.
HIGHMEDLOWFLAG
v1.0 June 2026 · v1.1 July 2026 (enforcement update) · Every finding confidence-rated · Three-pass validation · Sources documented

Read the analysis

Published findings are versioned and dated, and they update as the evidence does — the same three-pass discipline every 5Q engagement is delivered with. Reading it tells you exactly what you'd be buying.

Open the analysis overview

Discuss these findings →

Also in the library: Why Software Vendors Can’t Audit Their Own AI →

From the Privacy Series: WOPR Is a Privacy Law →

About

Built at the seam where claims, algorithms, and regulations meet.

5Q Health LLC was founded by Tabatha James, who spent more than a decade delivering front-line, client-centered clinical care in rural, underserved communities — serving patients across Medicaid, Medicare, and commercial coverage, where regulatory change, coverage denials, and appeals were a daily reality of practice, not a policy abstraction. She then crossed to the supplier side as an ATP/SMS — an Assistive Technology Professional and Seating & Mobility Specialist, evaluating and equipping patients with complex rehab technology in the FDA Class II medical device sector, one of healthcare's most heavily regulated and denial-intensive categories — through the very years automated denials ramped up (2019–2025). This dual perspective on prior authorizations shows in 5Q's claim, coverage policy, and denial letter literacy.

That hands-on fluency in compliance and risk is now paired with formal training in AI governance, privacy, and health law and policy (MS, Health Law & Policy, Wake Forest University School of Law, in progress). The combination was built to answer one question with precision: what does algorithmic adjudication do to this specific claim, in this specific market — and who is accountable when it gets it wrong?

5Q Health is based in Henderson County, North Carolina, and works with the rural safety net it comes from — the clinics, suppliers, and communities where a wrongly denied claim isn't a data point, but a person who doesn't get what they need.

TABATHA JAMES · AIGP · OTR · RESNA ATP/SMS
MS, HEALTH LAW & POLICY — WAKE FOREST UNIVERSITY SCHOOL OF LAW (IN PROGRESS)
MIT APPLIED DATA SCIENCE PROGRAM
Clinical credibility
OTR and RESNA ATP/SMS. A decade of front-line clinical practice across Medicaid, Medicare, and commercial coverage — prescriber, then supplier-side — working both sides of the claims this work protects.
Technical fluency
AIGP-certified AI governance, grounded in completion of the MIT Applied Data Science Program: AI/ML model design, development, and testing — convolutional neural networks, multi-modal models, and data-treatment fundamentals. That hands-on footing informs the bias-audit, transparency, and vendor due-diligence methodology this work applies.
Legal literacy
Graduate training in health law and policy. Coverage rules, the federal grant regime, and state AI law — the rules this work is defensible under.
How an engagement works

Three steps. No surprises.

Step 1 · Free

Scoping call

Thirty minutes, no charge. You describe the denial pattern, the payer notice, or the question. We decide together whether there's a fit.

Step 2 · In writing

Letter of engagement

Scope, deliverables, dates, and a fixed fee — confirmed in a short letter before work begins. Invoiced 50% at signing, 50% at delivery.

Step 3 · Delivered

Findings you can act on

A confidence-scored deliverable, a live readout with your team, and a roadmap ranked by what protects revenue first.

Scope & boundaries. 5Q Health provides regulatory analysis, governance, and operational advisory — not legal advice and not financial audit. Where a matter requires a legal opinion or financial-statement assurance, 5Q works alongside your counsel and accountants rather than in their place. For grant-funded organizations, 5Q engages as a contractor under the Uniform Guidance determination test (2 CFR 200.331) — a clean, low-burden procurement relationship.

The gate is already deciding. Govern it.

A thirty-minute scoping conversation is free, and worth having before the next plan year locks in.

Book a scoping call