ClaimIQ was built by Alexander Lopera — Managing Partner of American Medical Health Alliance (AMHA) and a 27-year veteran of medical billing, insurance reimbursement advocacy, PA billing, and payer compliance across the Greater Houston area and beyond.
I started in medical billing in 1999 — co-founding Global Billing Services LLC, a company that specialized in medical tourism billing. We helped international patients who received care in the U.S. navigate the entire reimbursement process, managing a monthly claim inventory of 200–300 accounts. We traveled to Germany, Switzerland, and the Bahamas to build hospital and facility relationships directly — and we grew annual collections from $1.1M to $1.5M, a 26% increase, by doing one thing well: following every claim all the way through to payment.
That decade taught me something the industry rarely talks about openly: most revenue that practices lose doesn't get denied — it just never gets properly followed up on. Payers count on inertia. The practices that win are the ones with someone in their corner who understands how insurance processing actually works and stays on it.
In 2009, I founded American Medical Health Alliance (AMHA) — a patient advocacy and reimbursement firm focused on out-of-network care. When a patient receives treatment at a non-participating provider, most billing companies walk away. AMHA doesn't. We evaluate every billable component of the medical stay, prepare and submit the claims, and navigate them through every stage of the insurance process to a final determination. AMHA has been continuously operating in Houston for over 17 years.
During the same period, I ran AudX-MD — a niche billing firm specializing in insurance billing for Physician Assistants in orthopedic surgery. Insurers routinely applied Silent PPO discounts and CPT bundling to reduce PA reimbursements to as little as 30 cents on the dollar. AudX-MD built the workflow and payer expertise to systematically challenge those reductions — and consistently raised PA surgical reimbursements from 30% to 70% of billed charges for the orthopedic practices we served.
Simultaneously, I led InterMed Health, where we applied Insurance Compliance Management (ICM) — a methodology built on deep knowledge of internal payer logic that held insurers accountable to federal and state reimbursement guidelines. We recovered years of unclaimed money from contracting and non-contracting payers, MCO networks, and TPAs, with an implementation model that caused zero disruption to client staff workflows.
ClaimIQ was built on everything those four companies taught me across 27 years. Payers underpay systematically. Practices undercode silently. Modifiers get missed. Denials compound. The practices that recover the most are the ones with an expert looking at the data — not just the biller who submitted it. That's what ClaimIQ delivers, at a price point and turnaround time that independent practices can actually use.
Every company Alexander Lopera has built or led is rooted in the same expertise — understanding how insurers actually process claims, and making sure providers and patients get every dollar they're owed.
Founded to help patients navigate the complex reimbursement issues associated with out-of-network and non-participating providers. AMHA evaluates every billable component of a patient's medical stay, prepares claims for submission, and navigates those claims through every stage of the insurance process to final determination. With two decades of experience, AMHA's advocates are among the most knowledgeable out-of-network reimbursement specialists in Texas.
The culmination of 27 years of billing and reimbursement expertise — an AI-assisted, expert-reviewed audit service built for independent and specialty practices. ClaimIQ surfaces denial patterns, undercoding, modifier gaps, and payer underpayments that practices don't know they're missing, and delivers a prioritized, actionable findings report in days with flat-fee, transparent pricing.
Specialized in one of the most underserved billing niches in medicine: insurance billing for Physician Assistants in orthopedic surgery. Insurance groups routinely applied Silent PPO discounts and CPT bundling to reduce PA reimbursements dramatically. AudX-MD built a program that consistently raised PA surgical reimbursements from 30% to 70% of billed charges — transforming the financial bottom line for the orthopedic practices it served.
Applied Insurance Compliance Management (ICM) — a methodology built on deep knowledge of internal payer logic — to help healthcare organizations recover money payers owed but weren't paying. Recovered years of unclaimed reimbursements from contracting and non-contracting payers, MCO networks, and TPAs. Implementation was seamless, with no disruption to client staff workflows and immediate impact on organizational cash flow.
From medical tourism billing in 1999 to AI-assisted audits today — a career built entirely around one discipline: making sure providers get paid what they're owed.
Co-founded a medical billing and auditing company specializing in medical tourism, helping international patients recover reimbursements for U.S.-based care. Managed a monthly claim inventory of 200–300 accounts across large and mid-size clients. Built direct hospital and facility relationships through international travel to Germany, Switzerland, and the Bahamas.
Founded AMHA to fill the gap left by traditional billing companies: fighting for reimbursement when patients receive care at out-of-network and non-participating providers. AMHA evaluates every aspect of the medical stay, identifies all billable components, prepares the claims, and navigates them through every processing stage to final determination.
Led AudX-MD through its full operational period, developing a specialized billing program for Physician Assistants in orthopedic surgical practices. PAs are chronically underpaid by insurers who use Silent PPO discounts and bundling codes to suppress reimbursements. AudX-MD built the expertise to systematically challenge those reductions — and consistently delivered results.
Led InterMed Health's ICM program — using deep knowledge of internal payer logic to help healthcare organizations recover money payers owed under federal and state guidelines. Recovered years of unclaimed reimbursements from contracting and non-contracting payers, MCO networks, and TPAs with a seamless implementation that caused no disruption to client operations.
Launched ClaimIQ to make expert-level, AI-assisted billing audits accessible to independent and specialty practices. Built on 27 years of reimbursement expertise across four companies, ClaimIQ finds what practices are missing — denial patterns, undercoding, modifier gaps, payer underpayments — and delivers a prioritized, actionable report in days with flat-fee pricing and no surprises.
We tell you what we find — good and bad. If your billing is clean in an area, we'll say so. We have no incentive to inflate findings or manufacture urgency. Our reputation is built on accuracy, not alarm.
AI is our analytical engine, not our product. Every finding is reviewed by someone with 27 years of billing expertise before it reaches you. We use technology to scale human expertise — not replace it.
A finding that isn't actionable isn't useful. Every item in a ClaimIQ report comes with a specific corrective action, a responsible party, and a timeline. We don't deliver findings — we deliver a roadmap.
Patient data never enters our workflow. We de-identify before we analyze. HIPAA compliance isn't a checkbox — it's the foundational operating principle every ClaimIQ engagement is built around.
We're not your billing company, and that's by design. As an independent auditor, we have no incentive to protect your current billing setup. Our only job is to find what's wrong and tell you the truth about it.
Full Practice Audits in 5–7 days. Spot Audits in 3–4. Free health checks within one business day. We know that time is money in a medical practice — we don't make you wait weeks for answers.
ClaimIQ is a service of American Medical Health Alliance LLC — a Houston-based out-of-network reimbursement advocacy and medical billing firm founded in January 2009. For 17+ years, AMHA has specialized in the cases most billing companies won't take: patients who received care at non-participating providers and need a knowledgeable advocate in their corner from claim preparation through final insurance determination.
Visit amhabilling.com →17+ years of continuous operation with deep familiarity in Texas payer environments including BCBSTX, UHC Texas, and Harris County provider market dynamics.
AMHA navigates the most complex reimbursement scenarios — out-of-network claims, non-participating providers, and medical tourism — where most billing companies stop at submission.
Across four companies and three decades — medical tourism, PA billing, ICM payer compliance, and OON advocacy — we've spent our entire careers making sure providers and patients get paid what they're owed.
Book a free 20-minute billing health check and put that experience to work for your revenue cycle.
Houston, TX · Serving practices nationwide · HIPAA-compliant