Every gap in care, visible before the visit.
One platform across the care continuum — so your clinicians spend the day with patients instead of the evening with charts.
- Diagnosis gapChronic kidney disease staged in the labs, absent from the assessmentEvidence · eGFR 41 on 12 Mar and 08 Jun · nephrology note 14 JunQuery readyRiskIQProgram openingMeets remote monitoring criteria, never enrolledEvidence · Two hypertension readings above goal since AprilConsent script queuedCareIQ
Illustrative findings · not real patient data
Care happens in the room. Your organization is judged on the record.
The work your teams absorb, and the part of it that quietly fails.
Charting follows the physician home.
The record is read before the visit and the note is written as the visit happens.
Care is delivered and never captured.
Every gap the record supports is named at the point of care, with the language already drafted.
Six vendors, six logins, one problem nobody owns.
One platform across the care continuum, and one team accountable for the result.
Documentation that would not survive an audit.
Sentence, page, and date behind every finding and every code, from the first day.
Programs that qualify on paper and never run.
Care management, monitoring, and follow-up run as a program, documented as it happens.
Every rollout needs a project team.
Start with one module, inside the systems you already use. No migration.
Modules that transform the organization. One record. One evidence trail.
Walk in already knowing the patient.
One page per patient: every care gap, every diagnosis, every service the record already supports.
- The whole record read before the patient arrives
- Diagnosis, service, and care gaps named in plain language
- Documentation and codes written as the note is signed
| Time | Patient | Gap found | Code | Evidence |
|---|---|---|---|---|
| 08:20 | M. Torres | Advance care planning discussed, never documented | 99497 | 3 chart facts |
| 09:00 | R. Chen | Kidney disease staged in labs, absent from assessment | N18.31 | 3 eGFR draws |
| 09:40 | A. Gomez | Obesity counseling delivered, not captured | G0447 | BMI 34.1 |
| 10:20 | D. Kapoor | Depression screening overdue 14 months | G0444 | Last done 14 mo |
| 11:00 | P. Shah | Wellness visit components split across three visits | G0439 | Provider input |
“Advance care planning discussion, 18 minutes, with patient and daughter present. Reviewed goals of care, surrogate decision-maker, and completion of healthcare proxy form...”
Illustrative example · not real patient data
Type 2 diabetes with CKD (E11.22) · Chronic diastolic HF (I50.32) · CKD stage 3a (N18.31) · Hypertension (I10).
Colonoscopy 2019 (due 2029) · Mammogram overdue by 7 months · Diabetic eye exam overdue · Pneumococcal complete.
eGFR has been under 60 on three draws across 9 months. Does the record support a documented CKD stage this visit? Agree · Disagree · Need more information.
Nothing is surfaced without the chart sentence behind it. A person accepts or rejects every finding — nothing files itself.
We read and write where your teams already work, through the interfaces your vendor already supports. Nobody adds a second screen to their day.
Pick the problem costing you the most. Adding the next module is configuration, not another implementation.
The same chart, with very different obligations attached to it.
Independent offices and multi-specialty groups, hospital-owned physician networks, the management services organizations that run their back office, the revenue cycle companies that code and verify for many practices at once, health plans, and the groups that carry capitation or shared savings. All of them work from the same chart. What each one has to prove with it is not remotely the same.
It sits beside the record system you already pay for.
- Epic
- Oracle Health
- athenahealth
- eClinicalWorks
- NextGen
- Veradigm
- Elation
- AdvancedMD
- DrChrono
- Greenway
- Practice Fusion
- Office Ally
Interface support varies by edition · ask us about yours
What clinical and financial leaders tell us.
Placeholder quotes · named references published after approval
Built by the people who had to live with the paperwork.
Internal medicine physicians
Practicing clinicians who have carried the panel, signed the notes, and answered the payer query. They decide what belongs in a chart and what is noise.
Revenue cycle experts
Veterans of eligibility, coding, denials, and payer contracts who have run revenue cycles at scale and know exactly where the money leaks.
AI, NLP, and ML engineers
Engineers who build clinical language systems that cite their sources, hold a code until the chart supports it, and keep a human in the loop by design.
The rules everyone asks about, answered plainly.
Yes. Payment year 2026 is the first year Medicare Advantage risk scores are calculated entirely under V28, after a phase-in of 33 percent in 2024 and 67 percent in 2025. V28 pays on 115 HCCs against 86 in V24, and 7,770 risk-adjusting ICD-10-CM codes against 9,797. Related conditions inside a disease family are constrained to identical coefficients, so a vaguer code inside the family no longer costs less than a precise one — it simply may not map at all.
Checked againstCMS CY2024 Rate Announcement; CY2026 risk adjustment implementation
See it on your own data.
Tell us what your organization is fighting — open care gaps, documentation, denials, coverage — and we will walk you through the part of the platform that closes it.