J2 Health Automated Complex Billing and Tax Compliance with Tabs and Anrok

About J2 Health

J2 Health is a data-driven platform designed to help health plans meet adequacy standards, ensuring they have the right number of providers in the right place to serve their members. Their adequacy tool supports insurance companies in fulfilling regulatory requirements by analyzing provider networks at scale, surfacing gaps, and optimizing coverage across states. Under the hood, J2 is a deeply technical platform built to streamline one of the most complex and compliance-heavy challenges in the healthcare ecosystem.

The Challenge: Manual Work, Missed Deadlines, and Unaccounted for Tax

As a growing startup with a small team and complicated contractual obligations, J2 Health’s billing and tax operations were messy and manual. Contracts varied widely—some billed monthly, others quarterly or annually—and pricing often depended on how many states a client operated in. “Every customer's contract looks different, with different billing terms, pricing, and products,” said Anthony Fowler, VP and Head of People and Operations. “We really needed a solution that could parse out all of the different details so we could bill folks properly, that was accurate and professional.” 

Before implementing Tabs, invoicing was done manually through QuickBooks, without a robust system for parsing contracts or applying logic based on contract terms. As standardization was impossible, this quickly became time-consuming. Sales tax compliance was similarly ad hoc and error-prone. “There were a lot of outstanding tax bills,” Anthony recalled. “Basically, we were just responsible as individuals to go into each state’s system and file taxes. We had over $100,000 in tax bills that were just sitting.”

The result was a set of manual workflows that were time-consuming, inconsistent, and hard to maintain. As the team grew and shifted, compliance became harder to manage and there was no reliable foundation to build on.

Why Tabs?

With a lean team and highly variable contracts, J2 needed more than just automation, they needed a system with built-in logic and controls that could turn complex contract terms into accurate, compliant invoices. Tabs gave them a structure they could trust, without needing to build it from scratch.

Tabs stood out for its ability to extract key terms from inconsistent contracts and automate invoice creation based on that logic—critical for a company whose pricing varied by customer, contract cadence, and geography. Just as importantly, Tabs integrated seamlessly with Anrok, the sales tax automation platform J2 adopted alongside a new fractional finance team. According to Anthony, “The Tabs integration has been super helpful because we’ve been able to have Tabs and Anrok  automatically calculate sales tax directly in the customer invoice.”

That integration marked a turning point. After years of manual compliance and backlogged tax bills, J2 finally had a unified billing and tax foundation that could scale—without adding headcount and without disrupting business continuity. According to Anthony, 

“My number one goal was: How do I make our financial operations systematic and not dependent on me or my knowledge? If I were to be here today, not here tomorrow, everything can still run and function and not have a major impact on the business. That was the mission-critical capability that we indexed for, and Tabs allows that.” 

Why Anrok?

For tax compliance, J2 Health needed peace of mind. With over $100,000 in unfiled tax obligations across multiple states, manually navigating each state’s portal was no longer viable. Anrok stepped in to centralize, calculate, and automate sales tax filings at scale. Anrok gave the team confidence that nothing would fall through the cracks, regardless of who was managing the process.

“The Tabs integration [with Anrok] has been super helpful because we’ve been able to have it automatically calculate sales tax… we’ll meet the baseline requirements of states so that we’re not delinquent in any way.”

Life With Tabs and Anrok

Since implementing these two solutions, J2 Health has built a billing and tax engine that runs with minimal oversight. Tabs extracts key contract terms, generates invoices, and syncs payments with QuickBooks. Anrok calculates the correct sales tax for each jurisdiction and files it automatically. The two systems work in tandem, ensuring accurate, compliant invoicing across J2’s customer base.

“I’ve referred several colleagues to Tabs because it enables you to operate and scale with a lean team. We don’t have to staff a full finance department to run a reliable billing engine… Tabs handles the complexity so we can stay focused on our core business.” – Anthony Fowler, VP and Head of People and Operations at J2 Health

Even while relying on an outsourced fractional finance team, Tabs gives J2 the structure and dependability of a mature billing operation. According to Anthony, “I've referred a few colleagues who are in similar roles as mine to Tabs. Tabs has such robust automation and helps us run things under the hood so well that it protects us from not having that deep knowledge.”

Today, billing and tax compliance happen in the background, with minimal manual intervention and guesswork. With Tabs, J2 can safeguard institutional knowledge, reduce operational risk, and stay focused on growth - not paperwork.