Medicaid Coverage Readiness for behavioral health

Protect coverage.
Preserve care.

Preserva AI helps behavioral health organizations identify Medicaid patients at risk of coverage disruption and prioritize what staff should do next before care or reimbursement is interrupted.

Become a Design Partner See How It Works

Designed for Medicaid-heavy behavioral health organizations. Built to work alongside the systems teams already use.

Coverage review queue Concept

  • Patient A

    Renewal due in 18 days · mailing address may be outdated

    Review

  • Patient B

    Renewal packet not yet confirmed as returned

    Assign

  • Patient C

    Coverage status changed since last visit

    Verify
Illustrative concept with fictional examples — not real patient data.

The problem

Coverage problems are often discovered too late.

Coverage changes

Coverage can be interrupted when renewal steps or notices are missed — sometimes before the care team is aware.

Fragmented information

Signals are spread across the EHR, payer portals, spreadsheets, and staff knowledge.

Late discovery

Gaps often surface at check-in or after a denied claim, when care and reimbursement are already at risk.

Building first

Starting with Coverage Readiness

Coverage Readiness means knowing which Medicaid patients may be at risk of losing coverage, why they may be at risk, and what staff should review or do next before disruption occurs.

  1. 1Patient populationYour Medicaid patients
  2. 2Identify riskWho may lose coverage
  3. 3Understand whyPlain-language reasons
  4. 4Prioritize actionWhat needs attention first
  5. 5Assign workRoute to the right staff
  6. 6Track resolutionFollow each case to an outcome

Staff stay in control. Ambiguous or consequential decisions remain with people, not software.

Implementation

Built around the systems you already use.

Keep your EHR.

Preserva AI is being designed to sit alongside your EHR, not replace it. Early versions may work from the reports, exports, and data workflows your teams already use.

  • Start with existing data

    Early versions are intended to begin with reports and exports teams already produce, so a deep integration doesn't have to be the first step.

  • Minimize implementation burden

    The aim is a light lift for IT and operations teams who are already stretched.

  • Integrate where it matters

    Deeper integrations may be added over time, where they create meaningful value.

Where we're headed

Coverage Readiness comes first.

Over time, Preserva AI aims to become an intelligence and workflow layer for Medicaid-heavy behavioral health organizations, starting with one problem.

Building first

Coverage Readiness

Will this patient remain covered?

Our current focus, being developed through customer discovery.

Future direction

Service Readiness

Is everything in place for this service?

Future direction

Claim Readiness

Is this encounter ready to be billed?

Why now

Medicaid is changing.

Changes to Medicaid eligibility and renewal workflows beginning in 2027 are increasing the importance of proactive coverage monitoring and operational readiness.

Preserva AI provides operational information, not legal advice or Medicaid eligibility determinations.

Organizations serving substantial Medicaid populations may want to evaluate how they currently:

  • Identify approaching coverage risks
  • Help affected patients
  • Verify coverage
  • Track unresolved cases

What does H.R. 1 mean for Medicaid providers?

Design partners

Help shape Coverage Readiness.

Your team already manages this problem. We want to learn how your workflow works today and build around it.

Become a Design Partner

You may be a fit if your organization:

  • Serves a meaningful Medicaid population
  • Manually monitors eligibility or renewals
  • Uses reports, spreadsheets, payer portals, or staff processes alongside the EHR
  • Is preparing for Medicaid changes beginning in 2027
  • Is willing to show us how the current workflow operates
Eddie Mazariegos

Eddie Mazariegos

Founder, Preserva AI

Eddie Mazariegos is an EdTech entrepreneur and former management consultant. His recent work alongside behavioral health organizations surfaced recurring challenges around Medicaid workflows, documentation, coverage continuity, and reimbursement—helping inspire Preserva AI. He is also the Founder & CEO of Future Gen.

FAQ

Common questions

What is Coverage Readiness?

Coverage Readiness means knowing which Medicaid patients may be at risk of losing coverage, understanding why they may be at risk, and knowing what staff should review or do next before an avoidable coverage disruption occurs. Preserva AI is intended to support staff follow-up. It does not determine eligibility.

What is H.R. 1 and why does it matter for Medicaid providers?

H.R. 1 became Public Law 119-21 on July 4, 2025. CMS refers to its Medicaid provisions as part of the Working Families Tax Cut legislation. The law includes significant Medicaid eligibility and administrative changes, including:

  • Six-month renewals. Beginning with renewals scheduled on or after January 1, 2027, most people enrolled in the Medicaid adult expansion group must have their eligibility redetermined every six months, rather than generally once a year.
  • Community engagement requirements. These begin January 1, 2027, for certain applicable Medicaid adults, unless a state implements them earlier.

These provisions do not apply to every Medicaid enrollee. Statutory exceptions and exclusions exist, and implementation varies by state. Providers serving affected populations may see more frequent coverage changes, renewal activity, patient questions, and cases that need follow-up. Eligibility determinations remain with state Medicaid agencies.

Learn more on Medicaid.gov

How could H.R. 1 affect behavioral health provider revenue?

H.R. 1 does not automatically reduce a provider's reimbursement. However, more frequent eligibility reviews and new requirements for some Medicaid beneficiaries could increase the risk of temporary coverage interruptions or unresolved eligibility issues.

When a patient's coverage is interrupted, a provider may face:

  • Delayed reimbursement
  • Uncompensated services
  • Interrupted care
  • Additional staff time responding to unresolved coverage
  • Greater uncertainty about whether services will ultimately be reimbursed

The effect could vary widely depending on the population served and on state implementation.

How could H.R. 1 increase administrative work for provider teams?

The law primarily creates requirements for states and affected Medicaid beneficiaries. It does not impose a blanket new legal obligation on behavioral health providers to administer Medicaid eligibility.

Still, organizations serving affected populations may choose, or operationally need, to spend more time on activities such as:

  • Monitoring upcoming renewals
  • Checking coverage status
  • Identifying patients who may need help
  • Patient outreach
  • Helping patients understand notices
  • Helping gather documentation
  • Reviewing information that may relate to an exception or exclusion
  • Coordinating with eligibility teams, Medicaid agencies, or managed care organizations
  • Tracking unresolved coverage cases
  • Confirming whether coverage was successfully renewed

This potential increase in operational work is one reason Preserva AI is exploring Coverage Readiness.

Learn more about community engagement on Medicaid.gov

Who is Preserva AI for?

Our initial focus is Medicaid-heavy behavioral health organizations, such as:

  • Community mental health organizations
  • CCBHCs
  • SUD providers
  • Youth and family behavioral health organizations
  • Other human services organizations serving substantial Medicaid populations
Does Preserva AI replace our EHR?

No. Preserva AI is being designed as an intelligence and workflow layer that works alongside your existing systems, not a replacement for your EHR.

Do you require an EHR API?

Our goal is to minimize implementation burden. We're exploring early versions built around reports, exports, and existing provider data workflows, so a deep EHR integration doesn't necessarily have to be the first step. Deeper integrations may be added where they create meaningful value.

Does Preserva AI determine Medicaid eligibility?

No. Medicaid eligibility determinations remain with the applicable state Medicaid agency. Preserva AI is intended to help provider teams identify potential risks, organize relevant information, prioritize follow-up, and track operational resolution.

Is Preserva AI available today?

Not yet. Preserva AI is early-stage. Coverage Readiness is being developed through customer discovery and design-partner conversations.

What does becoming a design partner involve?

Design partners help us understand how Medicaid coverage workflows operate today. That may include:

  • Showing us the existing workflow
  • Explaining where staff spend time
  • Identifying where information lives
  • Reviewing early concepts or prototypes
  • Helping us understand what would make the product genuinely useful

It's a collaborative conversation. It doesn't create a contractual obligation or require sharing patient-identifiable data. Start with the short design partner form.

Protect coverage. Preserve care.

If your organization serves a substantial Medicaid population, we'd like to learn from your team.

Become a Design Partner