How Real Deal Protected $339K in Authorization Revenue with Cue

About Real Deal

Real Deal Therapy and Wellness is a multi-level behavioral health provider with PHP, IOP, and sober living programs, serving clients with substance use disorder and co-occurring mental health conditions. Led by Chief Clinical Officer Sharaya Gallozzi, LMFT, Real Deal operates a high-acuity census where every continued authorization, every off-hours decision, and every flagged risk signal compounds into the bottom line.

The challenges Real Deal faced

Every multi-LOC behavioral health operator lives in the same brutal math. Continued-stay authorizations are due every three to seven days. Peer reviews come faster than ever. The clinical case for medical necessity depends on data the team isn't capturing in real time. Real Deal felt all of it.

The clinical team saw the four problems eating into the operation:

Off-hours invisibility. Clients hit cravings, panic spikes, and SI escalation outside of session hours. The clinical team would find out at the next session, or not at all.
AMA pressure. Clients leaving against medical advice usually weren't a surprise to anyone in retrospect. The warning signs were there. They just weren't visible until it was already too late.
UR documentation that didn't hold up. Peer reviews demanded clinical evidence Real Deal couldn't always assemble fast enough. Clinical staff wrote UR summaries from memory and chart notes. The data was thin.
Clinical efficiency drag. Group notes, individual session prep, medication tracking. Clinicians were spending hours a day on tasks that didn't move patient outcomes forward.

"Cue helps us identify which clients need to be placed on the AMA board for close monitoring. We're able to be proactive and keep a lot of them from needing a higher level of care." Sharaya Gallozzi, LMFT · Chief Clinical Officer, Real Deal

How Cuepri's Cue solved Real Deal's challenges

Real Deal piloted Cue across its census for nine months. For clients without smartphones, Cuepri supplied locked-down dedicated devices so no one was left without access. Cue became embedded in daily clinical operations within weeks: an average of 101 unique active clients each week, the large majority of the active census, engaging in check-ins, off-hours conversations, assessments, and crisis support 24/7.

Workflow changes were modest. The clinical team checks Cue insights every morning before the day starts. Clinicians use Cue-generated note summaries, direct client quotes, and pre-scored assessments to prep group and individual sessions. The UR team works from Cue-generated clinical summaries when defending continued authorizations. Medical staff get real-time medication alerts before issues compound. No additional training. No competing logins. No disrupted routines.

"Anytime we ask the Cuepri team to add, remove, or update something, it happens. They're incredibly fast to respond and receptive to our suggestions and feedback." Sharaya Gallozzi, LMFT · Chief Clinical Officer, Real Deal

The results for Real Deal with Cue

$339K in protected authorization revenue

This was the story Real Deal's own UR team ran the numbers on. Ashley and Adam, Real Deal's UR analysts, looked at continued-stay reviews across a representative period and asked one question: in how many of these did Cue data make the difference?

The answer:

Cue data was rated useful in roughly 15% of all UR reviews each week, with 83% of those happening at the PHP level.
Four reviews per week were identified as cases where Cue data was decisive in securing the authorization (three PHP, one IOP5).
At $1,800 per PHP continued auth and $1,125 per IOP5, that's $6,525 per week. Annualized: roughly $339,000.

Cue provided clinicians with one-page summaries pulling weekly PHQ-9 and GAD-7 scores, real-time conversational data on stressors and functional impairments, direct client quotes, and intensity-and-frequency quantifications. The data lived in one place. The UR team had it before peer review, every time.

"When there's a peer review I don't need to worry, because I can always look at the Cue summary and the data to advocate for more time." Sharaya Gallozzi, LMFT · Chief Clinical Officer, Real Deal

AMA blocking and off-hours risk coverage

Cue runs 24/7. Real Deal's weekly averages tell the rest of the story:

~41 off-hours support conversations across ~22 unique clients per week.
In 87% of those conversations, clients self-reported a measurable reduction in distress score following Cue's intervention, measured before-and-after on a 1-10 scale.
~16 unique clients per week flagged with SIHI-level alerts, delivered to clinical staff in real time.
~49 unique clients per week surfaced with struggle or relapse indicators.
~36 unique clients per week with medication-related alerts (refills, concerns, updates).

The intervention layer mattered as much as the visibility. Clients who would have suffered through a 3 AM panic spike alone now had somewhere to go that wasn't an ER or a relapse. The clinical team saw the conversation, the alert, and the de-escalation outcome before the next session started.

"We've been able to gain trust from clients who usually just AMA or step up to a higher level of care." Sharaya Gallozzi, LMFT · Chief Clinical Officer, Real Deal

Clinical efficiency that compounds

Sharaya and her clinical leadership team measured Cue's impact on clinical staff time:

20-30 minutes saved per clinician per day on group notes. Paper check-ins replaced with auto-generated bullet points and ready-to-paste client quotes.
10-15 minutes saved per individual session, roughly 20% of session prep time. Weekly assessments completed in-app instead of in-person, with scores and trend visualizations already displayed.
UR notes written faster, with better data. Clinicians now pull personalized client quotes, scores, and quantified intensity-and-frequency measures straight from Cue for every authorization summary.

Multiply the time savings across the clinical team and across a month, and Cue effectively returns clinical headcount to Real Deal at no incremental cost.

Honest data, finally

Maybe the most important result. Real Deal discovered that clients were giving Cue information they wouldn't give their therapists in person.

"Clients are being more honest with Cue than their own therapist. And assessments done in the app are more accurate than the ones they do in-person too." Sharaya Gallozzi, LMFT · Chief Clinical Officer, Real Deal

That changes everything downstream. Treatment plans built on better data. UR cases backed by client-truth, not client-survey-fatigue. Clinicians working from a more accurate baseline of each patient's actual life.

What's next for Real Deal × Cuepri

Real Deal is in growth mode. Cuepri's roadmap lines up with where they're heading:

Client sentiment data. Real-time pulse on how clients rate their therapist, their groups, and their overall experience. Cue surveys at intake, every two weeks, and at discharge.
Staff sentiment. Anonymized check-ins on workload, recognition, mission alignment, and curriculum confidence. Built to catch turnover risk early.
Multi-location executive dashboard. AMA-risk clients, staff turnover risks, engagement and attendance barriers, acuity-weighted caseload metrics, and program experience themes across every location in one view.
Attendance tracking. Automated reconciliation of billable vs. scheduled days, no-show pattern surfacing, and reduced manual error on a process that directly affects revenue.

"Knowing how clients score their therapist and therapy group will increase our ability to provide better care and assess our employees." Sharaya Gallozzi, LMFT · Chief Clinical Officer, Real Deal

What Real Deal proved is straightforward. When continuous engagement runs underneath the clinical workflow, every part of the operation gets sharper. Authorizations come in cleaner. AMAs get blocked earlier. Clinicians spend more time on patients, less on documentation. And clients tell the truth.

That isn't a faster horse. That's a different ride.

How Real Deal protected $339K in authorization revenue.