Ethan Schwarzbach Launched Flychain to Fix ABA Clinic Cash Flow

The Dentist’s Son

NEW YORK — Ethan’s father, a successful dentist, was not paying himself. The dentist was running a thriving dental practice, seeing patients, managing staff, keeping the business operational, and yet for months at a stretch, he was not drawing a salary. His son, Ethan, who by then had spent several years in fintech and trading, started digging into why. The answer was straightforward and systemic: insurance payment lags. The time between delivering care and receiving payment, typically 30 to 90 days for dental claims but often longer when denials and resubmissions are involved, created a cash flow gap that made it impossible for a small practice owner to pay himself consistently while also covering payroll, rent, supplies, and operating expenses.

After extensive research, Schwarzbach realized the problem was not unique to dentistry. It existed across healthcare, in every specialty where small and mid-size providers depend on insurance reimbursement as their primary revenue source. The gap between delivering care and receiving payment, compounded by the administrative complexity of billing, coding, authorization, and denial management, creates a structural cash flow crisis that forces providers into impossible choices: borrow at predatory rates, delay vendor payments, defer their own compensation, or sell to a larger organization that has the capital reserves to absorb the lag.

For ABA therapy providers, the problem is even more acute. ABA claims involve complex CPT codes (97151 through 97158), stringent medical necessity documentation, payer-specific authorization requirements, and post-payment utilization reviews that can claw back reimbursement six to 24 months after services are delivered. A small BCBA-owned practice delivering 500 hours of ABA per month might be owed $150,000 in outstanding claims at any given time, with no certainty about when, or whether claims will be paid. Documentation errors account for up to 42% of ABA claim denials in some audits. The ABA Coding Coalition has noted that caregiver training claims (97156) face rejection rates as high as 30% when documentation does not meet the teach-back standard.

The financial infrastructure that large PE-backed providers use to manage this complexity, dedicated billing departments, lines of credit, professional CFOs, treasury management, and actuarial forecasting, does not exist for the independent clinician who opened a practice to help kids, not manage a balance sheet. The result is a structural disadvantage that pushes independent providers toward one of two outcomes: slow suffocation by cash flow, or sale to a private equity firm that has the capital reserves to absorb the lag. Flychain is designed to create a third option: financial infrastructure scaled to the independent practice, at a cost the independent practice can afford.

BCBAs who got tired of the waitlists decided to open their own clinics. They did not go to school to become CFOs. They went to school to help kids. And somehow, on top of all of that, they have to become their own bookkeeper, their own tax strategist, their own CFO. The least we can do is make that part easier.

Duke to Wall Street to Fintech

Schwarzbach graduated from Duke University in 2011 with a bachelor of arts in public policy analysis. His first job out of college was on a trading desk, where he learned the mechanics of capital markets, price discovery, and risk management. From there, he built a career across the fintech and financial services landscape: Charleston Capital Management, where he developed skills in investment analysis and financial modeling; inFactor, a factoring and lending firm where he learned how working capital products serve small businesses; and Ocrolus, a document verification and OCR technology company that processes financial documents for lenders and banks. The common thread was infrastructure: at each stop, Schwarzbach worked on the systems that connect money to the businesses that need it.

The Duke public policy degree is a less obvious preparation for fintech than a finance or CS degree, but it is arguably a better one for the specific company Schwarzbach ended up building. Public policy analysis trains you to think about systems, incentives, and unintended consequences. It asks: who benefits from the current arrangement, who is harmed, and what would have to change to produce a different outcome? Applied to the ABA industry, the question becomes: why does a system that was designed to fund treatment for children with autism end up creating cash flow crises for the providers delivering that treatment? The answer lies in the gap between how insurance reimbursement is structured and how small businesses actually operate, a gap that public policy analysis is designed to identify and that fintech is designed to close.

It was at Ocrolus, where Schwarzbach worked with lending data modeled on insights from Square’s merchant processing infrastructure, that the Flychain idea crystallized. Square had demonstrated that real-time payment data from a business’s point-of-sale system could be used to underwrite lending decisions faster, cheaper, and more accurately than traditional methods. Schwarzbach asked the equivalent question for healthcare: who has the analogous data? The answer was billers, the revenue cycle management companies that process insurance claims for healthcare providers. Their data, the claims submitted, the payments received, the denials issued, and the time-to-payment patterns, contained exactly the kind of financial signal that a lending platform could use to underwrite small healthcare practices.

Schwarzbach met his co-founder, Jaime Deverall, through the MoVi Community, a network for founders and operators in fintech. Deverall, who serves as CTO, brought engineering expertise and, in a detail that captures the startup’s personality, a background as a backup singer for Wiz Khalifa. Schwarzbach brought the finance and healthcare domain knowledge. Together, they founded Flychain with a mission to optimize the financial health of small to medium-sized healthcare providers, starting with the most pressing problem: working capital.

The Financial Control Tower for ABA

Flychain describes itself as the “financial control tower” for healthcare practices, and ABA therapy has become its core market. The platform provides full-service bookkeeping and accounting tailored specifically for healthcare providers, revenue cycle management integration, capital planning, and access to funding products including lines of credit, term loans, and SBA loans. The company positions itself as a replacement for QuickBooks and generic accounting tools that do not understand the unique revenue patterns, billing cycles, and payer dynamics of healthcare businesses.

The product architecture follows the strategy Schwarzbach outlined in his Venture Everywhere podcast interview: use lending as a wedge to acquire customers, learn their financial pain points through the underwriting process, and then build the platform tools they need to manage their finances independently. “It’s counterintuitive for a fintech company to start with lending to then build the platform,” Schwarzbach said. “But for us, we asked ourselves, what better way to learn what other fintech tooling we need than to solve a cash flow issue in the form of lending, but also underwrite?” The approach means Flychain’s product development is driven by real data from real ABA practices, not by assumptions about what providers might need.

For ABA practice owners, Flychain’s value proposition is specific and operational. Schwarzbach advises new owners to plan their capital needs early to overcome initial financial hurdles and support growth. He stresses that maintaining clean, accurate financial records from day one is critical for securing loans, managing expenses, and eventually selling the business. The emphasis on clean books is not just financial housekeeping. It is the difference between a practice that has options, whether that means growing, borrowing, partnering, or selling on favorable terms, and one that is flying blind.

Schwarzbach started Flychain after discovering that his father, a dentist, was going months without paying himself despite operating a thriving practice. Insurance payment lags and a lack of working capital solutions were holding the practice back. The problem, he realized, exists across all of healthcare.

Partnerships and the ABA Ecosystem

Flychain has built strategic partnerships that position it at the center of the independent ABA practice ecosystem. In September 2024, the company announced a partnership with Raven Health, a clinical software provider for ABA practices. The partnership gives Raven’s clients access to Flychain’s bookkeeping, accounting, and capital tools, while Flychain’s clients gain access to Raven’s clinical data collection and practice management solutions. Richard Wagner, CEO of Raven Health, described the fit: “Flychain is great at helping startup providers optimize their finances and improve their cash flow, enabling them to further invest in their growing businesses.”

Flychain also partners with Camber Health on medical billing integration. Schwarzbach and Nathan Lee, CEO of Camber, have discussed on the Flychain Reaction podcast how clean billing practices connect directly to financial stability, using real-world examples including the fallout from the Change Healthcare cyberattack and TRICARE payment disruptions. The company sponsors the ABA C.A.R.E.S. Summit alongside Motivity, Rethink Behavioral Health, Verbal Beginnings, and other ABA industry platforms.

The partnership strategy reflects a deliberate choice to serve the independent ABA market rather than the PE-backed consolidators. The practices Flychain targets are the ones that the large platforms do not serve: solo BCBAs who opened a clinic, parent-founders who saw a gap, small group practices with 10 to 50 employees. These are the practices most vulnerable to cash flow disruption, most likely to lack professional financial management, and most at risk of selling to private equity not because they want to but because they cannot afford to stay independent. Flychain’s thesis is that better financial infrastructure keeps these practices independent, and that independent practices, run by clinicians rather than financial engineers, produce better outcomes for families.

The thesis has an implicit corollary: that the ABA industry’s consolidation wave was driven at least in part by financial fragility, not by clinical inadequacy. When an owner sells their practice to a PE firm, the narrative is usually about “partnering for growth” or “accessing resources to serve more families.” The less-discussed reality is often simpler: the owner could not manage the cash flow, could not afford a CFO, could not secure a line of credit from a bank that did not understand healthcare reimbursement, and ran out of options. If Flychain can solve those problems before the BCBA reaches that point, the entire calculus of the PE acquisition model changes. The founder who has financial stability, clean books, and access to capital on reasonable terms is a founder who can negotiate from strength rather than desperation, or choose not to sell at all.

Schwarzbach described this dynamic on LinkedIn after speaking with an ABA practice owner who had sold to a PE group: “I got off a call last week with an ABA practice owner who had sold her practice to a PE group.” The details of that conversation remain private, but the context is public: across the ABA industry, clinician-founders who sold to PE firms are increasingly vocal about what they gained and what they lost in the transaction. Flychain’s bet is that many of those sales were avoidable if the financial infrastructure had existed earlier.

Five Screenplays and a Financial Operating System

In a detail that captured attention in his Everywhere Ventures founder profile, Schwarzbach disclosed that he has written five feature-length screenplays. The hobby is unrelated to his professional life in every obvious way and related in the one way that matters: both screenwriting and startup building require the ability to construct a narrative, sustain tension across a long arc, and convince an audience that the story is worth their time. Schwarzbach’s narrative for Flychain, a Wall Street kid who watched his dentist father go unpaid, then built the financial operating system that keeps independent healthcare practices alive, is itself a story with the structure of a screenplay: a personal catalyst, a rising action through fintech, and a climax in ABA.

The ABA industry in 2026 is bifurcating. On one side, PE-backed consolidators with hundreds of millions in capital are acquiring independent practices at a rate that shows no signs of slowing. On the other, a growing number of BCBAs are choosing independence, driven by burnout, clinical autonomy, and the desire to build something aligned with their values. The second group needs financial infrastructure that the first group provides internally. Flychain is betting that it can be that infrastructure. If it succeeds, the independent ABA practice becomes a viable long-term business model rather than a waystation on the road to acquisition. The screenwriter from Duke, whose father could not pay himself, is writing the financial script that the industry’s clinician-founders need to stay in the story.

AT A GLANCE

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