REFERRAL TO REIMBURSEMENT

AI Native EMR

For Home Health.

AI REFERRAL SCREENING
PDGM 1CGK1 · MMTA-Cardiac
Homebound: CoP met
271: Coverage active
LUPA risk · 3 visits under threshold
ADMIT PACKET
AUTONOMOUS SCHEDULING
SOC booked inside the 48-hr window
Voice agent confirmed with patient
Discipline + continuity matched
Routes re-plotted overnight
SCHEDULING ASSISTANT
Patient prefers mornings — resequencing Tuesday route
DONE
Route saved 47 miles · confirmations sent ✓
AMBIENT AI DOCUMENTATION
M1830 Bathing coded from conversation
Wound R heel · 2.1 × 1.4 cm, staged from photo
22 meds reconciled in 2 pictures
OASIS-E DRAFTING
POINT-OF-CARE QA
Wound depth missing — capture before leaving the home
RESOLVED
Depth 0.3 cm captured · note is visit-complete ✓
AI-DRAFTED OASIS-E
All M-items drafted from the transcript
GG items consistent across sections
Orders + med list attached
60 minutes saved on this chart
CHART COMPLETE
AGENTIC QA REVIEW
HIPPS 1CGK1 confirmed against OASIS
2 discrepancies flagged, fixed in-app
Diagnosis sequencing validated
Chart audit-ready in minutes, not days
QA PASS
AI REVENUE CYCLE
837I outAvailityChangeWaystarOffice Ally
RCD pre-claim affirmed · UTN attached
Statuses & 835 remits flow back live
Underpayment caught · $412 variance
DENIAL MANAGER · 835 IN
CO-50 on G0299 units — appeal drafted from chart evidence
RESOLVED
Appeal accepted · resubmitted & paid in full ✓
VALUE-BASED CARE ANALYTICS
STAR RATING★★★★★★★★★★
4.5 — up from 3.5 in two quarters
HHVBP TPS ↑
Dyspnea improvement · 82nd percentile
HHCAHPS trending +6 pts this quarter
HHVBP payment adj · +3.2% projected
Screening referral, eligibility & LUPA risk…
THE PLATFORM

From Referral to Reimbursement, one complete platform.

One AI EMR that runs Home Health end to end

Referral parsed · PDGM 1CGK1
OK
Eligibility 271 · coverage active
OK
LUPA risk · 3 visits under threshold
ALERT
AI REFERRAL SCREENING

Every referral screened in minutes

CoP and homebound checks, automatic
Accept or return with reasons, in minutes
📅

Autonomous scheduling

Visits schedule themselves. The EMR reads frequency orders, authorizations, clinician availability, and drive time — then builds and maintains every calendar on its own.

Frequency compliance
Drive-time optimized
Auto reschedule
SN visit — M. Alvarez · Tue 9:00 AM
SCHEDULED
PT eval — J. Chen · Wed 1:30 PM
SCHEDULED
HHA visit — R. Patel · Fri 11:00 AM
REBOOKED
📅

Autonomous scheduling

RN
Sarah
MA
M. Alvarez · 9:00a
PT
Dave
JC
J. Chen · 1:30p
HHA
Amy
RP
R. Patel · 11:00a
📅

Autonomous scheduling

Week
Day
MON
M. Alvarez
9:00a · SN
J. Chen
1:30p · PT
TUE
R. Patel
8:30a · OT
D. Kim
11:00a · SN
WED
M. Alvarez
9:00a · SN
Open · auto-fill
THU
L. Ortiz
10:00a · PT
S. Brooks
1:00p · SN ↻
FRI
M. Alvarez
9:30a · SN
T. Nguyen
11:30a · HHA
See it in action
Scheduled
Rescheduled
Open shift
AUTONOMOUS SCHEDULING

The schedule builds itself

Voice agent confirms with the patient
Preference and skill matching, continuity kept
Clinician speaks OASIS-E DRAFT Ready to sign Documentation drafts itself during the visit
AMBIENT AI AT THE CORE

Every visit becomes structured notes in real time

Up to 60 minutes saved per visit
Notes ready to sign, not retype
Availity Connected Change Connected Waystar Connected Office Ally Connected AutoMynd CLAIMS ENGINE Claims out · statuses and remits back, automatically
MULTI CLEARINGHOUSE INTEGRATION

Every claim, every clearinghouse, one place

Stop logging into payer portals unless truly needed
Real-time claim status, end to end
Inovalon
Stedi
Waystar
Availity
98.4%
Clean claim rate at submission
CLEAN CLAIMS

Pre-flighted before it is ever billed

Fewer denials, faster reimbursement
Revenue you can forecast with confidence
EM Eleanor Mathis CHF · Episode 2 of 3 AUTHORIZATION 12 of 20 visits used MEDICATIONS Reconciled SCHEDULE Next: Thu · SN visit ALERT Re-auth due · 5 days Every team sees the same live patient picture
PATIENT 360

The whole patient, on one screen

Live auth status and remaining visits at a glance
Clinical, billing and intake all work from the same picture