Bridge of Hope Achieves $1.1M in Collections and Full Revenue Recovery with Prosperity Behavioral Health

Prosperity engaged Bridge of Hope under urgent conditions, beginning recovery work before standard onboarding was complete. The initial phase required a comprehensive audit of the facility’s billing history, contract structure, and credentialing status across all payers—an assessment that uncovered cascading systemic failures requiring parallel remediation tracks.

Credentialing was corrected from individual NPI to facility-level billing across 12+ payer contracts. Prosperity identified and pursued a contract amendment with Care Oregon to add a missing service line that had been omitted by a prior contractor—a gap causing an entire program’s claims to adjudicate as out-of-network. This amendment required direct payer advocacy, with Prosperity’s team attending Care Oregon meetings alongside Bridge of Hope’s clinical leadership to negotiate resolution. The facility had made more than 100 unanswered direct contact attempts before Prosperity achieved the credentialing breakthrough through existing payer relationships.

Billing methodology was rebuilt from the ground up: per diem code structures replaced per-service billing; stacked ancillary codes were activated for IOP encounters; peer support, transportation, and case management revenue streams were documented and submitted for the first time. A weekly Friday billing cadence was established to minimize lag between service delivery and claim submission.

The most technically complex initiative was the Kipu-CMD API integration, implemented to eliminate a manual spreadsheet billing workflow that required clinical staff to spend late nights on data entry and created significant billing delays. Implementation required custom payer rules configuration, HCPCS code mapping by payer and level of care, and multiple workbook revisions before go-live. Prosperity’s team navigated data integrity issues and face sheet corrections throughout, with the integration going live in mid-2026. Post-integration, billing errors dropped markedly.

Bridge of Hope opened in Portland, Oregon in July 2024 with a clear mission: deliver PHP, IOP, outpatient, peer support, medication management, and residential sober living services to populations—predominantly Medicaid-enrolled—who have limited access to quality behavioral health care. The facility grew quickly, reaching near-full census across its residential properties and treatment programs. But beneath that clinical momentum lay an existential financial crisis.

A prior billing vendor—an offshore firm operating on a flat-rate contract—had failed to obtain a single authorization for the facility’s primary payer for six consecutive months. The facility was effectively delivering free services. Compounding the problem: contracts had been credentialed under the owner’s individual NPI rather than the facility entity, a prior contractor had omitted an entire service line from the payer contract, and billing was being submitted using paper-based processes more than 15 years out of date. Purchased billing technology sat completely unused. Key revenue streams—peer support, transportation, case management, mental health assessments—were never billed at all.

Monthly operating expenses exceeded $120K while collections remained negligible. The facility’s owner—a mental health nurse practitioner and the sole financial decision-maker—personally funded operations out of pocket for months, watching the gap between expenses and revenue grow with no clear end in sight.

Bridge of Hope selected Prosperity Behavioral Health based on a combination of Oregon-specific Medicaid expertise, direct payer relationships, and comprehensive service scope that no single competitor could match. The facility had previously engaged a competing RCM vendor and an offshore billing firm—neither possessed the specialized knowledge required for Oregon’s CCO payer landscape.

Prosperity’s platform delivers end-to-end revenue cycle management purpose-built for behavioral health providers: authorization and utilization review management, credentialing and payer relations, claims billing and adjudication support, and billing optimization consulting. For Medicaid-dependent providers, Prosperity’s deep familiarity with Oregon CCO-specific billing requirements—including per diem code structures, H-code and T-code modifier strategies, level-of-care step-down optimization, and Care Oregon adjudication processes—represents a capability that generalist billing vendors cannot replicate.

Critically, Prosperity’s team maintains direct working relationships at the payer level with Care Oregon, Trillium, and Oregon’s commercial carriers—enabling advocacy that goes beyond claim submission into active contract amendment, rate dispute resolution, and credentialing escalation. The platform integrates with leading behavioral health EHRs including Kipu, enabling direct API-based claim transmission that eliminates manual data entry workflows and the billing lags they create.

Prosperity engaged Bridge of Hope under urgent conditions, beginning recovery work before standard onboarding was complete. The initial phase required a comprehensive audit of the facility’s billing history, contract structure, and credentialing status across all payers—an assessment that uncovered cascading systemic failures requiring parallel remediation tracks.

Credentialing was corrected from individual NPI to facility-level billing across 12+ payer contracts. Prosperity identified and pursued a contract amendment with Care Oregon to add a missing service line that had been omitted by a prior contractor—a gap causing an entire program’s claims to adjudicate as out-of-network. This amendment required direct payer advocacy, with Prosperity’s team attending Care Oregon meetings alongside Bridge of Hope’s clinical leadership to negotiate resolution. The facility had made more than 100 unanswered direct contact attempts before Prosperity achieved the credentialing breakthrough through existing payer relationships.

Billing methodology was rebuilt from the ground up: per diem code structures replaced per-service billing; stacked ancillary codes were activated for IOP encounters; peer support, transportation, and case management revenue streams were documented and submitted for the first time. A weekly Friday billing cadence was established to minimize lag between service delivery and claim submission.

The most technically complex initiative was the Kipu-CMD API integration, implemented to eliminate a manual spreadsheet billing workflow that required clinical staff to spend late nights on data entry and created significant billing delays. Implementation required custom payer rules configuration, HCPCS code mapping by payer and level of care, and multiple workbook revisions before go-live. Prosperity’s team navigated data integrity issues and face sheet corrections throughout, with the integration going live in mid-2026. Post-integration, billing errors dropped markedly.

The turnaround Bridge of Hope achieved in partnership with Prosperity is measurable at every level of the business.

$1.1M+ in total collections were confirmed as of August 2026, at a 93% collection rate—a figure Carmen Ramirez, Prosperity’s account lead, described as a milestone. Weekly revenue stabilized at $44K–$49K, a transformation from the near-zero collections that had threatened the facility’s survival. Monthly operating losses were cut in half—from $100K to $50K—within two months of Prosperity’s engagement, providing the financial foundation for continued operation and expansion planning.

Billing optimization compounded those gains. The PHP-to-IOP step-down billing framework with stacked ancillary codes generates approximately $270 per session compared to roughly $140 previously—nearly doubling per-encounter revenue capture. Nine active payer contracts are now in place, with seven additional contracts in progress, including Kaiser, TriWest/VA, and tribal insurance carriers.

The Kipu-CMD integration eliminated the manual data entry workflows that had consumed clinical staff hours late into the night, and stabilized billing error rates to a level the clinical team described as “very few mistakes.” With billing operations normalized, the facility’s owner—who had personally funded $140K+ to sustain operations through the crisis—was able to pursue and close on a second building acquisition, with Washington State expansion and RTC licensure in active development.

Bridge of Hope’s owner summed up the relationship directly: “We’re not going to change any billing company or anything, I can assure that, because we are going this positive direction.”