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Carob converts the hardest-to-enroll pediatric patients onto Medicaid — through disability pathways that self-service tools can't touch — and keeps their care covered through EPSDT. We work with the providers, pharmaceutical programs, and foundations who carry the cost when these children go uncovered.
Income-based Medicaid enrollment is now a five-minute self-service flow. The hard pathway — disability-based eligibility for medically complex children — remains manual, slow, and routinely skipped. A disabled child can qualify regardless of household income, but families can't self-assess "institutional level of care," so they never apply. Carob does the hands-on work of finding these children, assembling the evidence, and winning the case.
Disability-based eligibility ignores parental income in many pathways — but the rules are opaque, state-specific, and impossible for a family to navigate alone. Eligible children simply never enter the system.
Modern enrollment tools handle income-based renewals in minutes. Complex conversions need evidence assembly, eligibility expertise, and appeals — work that a self-service flow cannot do.
Complex kids go uninsured or under-covered. Providers absorb uncompensated care, and six-figure therapies go unreimbursed — which is why institutions, not families, are our customers.
Hospitals, specialty centers, and FQHCs convert charity care into reimbursed Medicaid revenue — including the 90-day retroactive window.
A converted patient is a reimbursed patient on a high-cost therapy. Compensation is fixed, fair-market-value, and drug-agnostic — never a share of drug revenue.
Disease-specific patient-services budgets fund coverage access for their own population of complex patients.
We identify disabled and medically complex children in clinical and coverage data, and convert them onto Medicaid via income-disregarding disability pathways — TEFRA / Katie Beckett, 1915(c) HCBS waivers, and SSI-linked Medicaid.
Once a child is enrolled, we use the EPSDT mandate — which covers any medically necessary service for under-21s — to win coverage for therapies that plans deny. A recurring event for every child.
Surface eligible kids from clinical and coverage data (EHR / HIE).
A rules engine maps each child to the right route by state and profile.
LLM-assisted documentation package with clinician and navigator sign-off.
File with the state, SSA, or waiver program; manage information requests.
Contest denials through fair-hearing rights — often where the case is won.
Secure coverage for specific medically necessary therapies.
A provable conversion record lets the provider bill recovered revenue.
Want a walkthrough of the conversion engine? Request a demo.
Cognitive science & HCI (Carnegie Mellon). MBA (Imperial College London). Engineering at Morgan Stanley — fixed-income derivatives and data pipelines.
Engineer at Meta (NYC). NLP background from Johns Hopkins. Owns the data and model stack.
Wharton MBA. Private equity and finance/operations leadership. Owns the financial model, go-to-market motion, and capital.
Supported by part-time ML engineering, and clinical & academic advisors across pathology and critical-data research.
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