Scheduling & availability
Weekly availability templates per provider, recurring exceptions, time-of-day capacity. Appointment book with drag-to-reschedule. Waitlist with auto-fill on cancellation.
III. pollenix.health
AI-native EMR · FHIR R4 · regulated
The EMR that ships with its reasons.
Pollen8 MR is a deployable AI-native EMR on FHIR R4. Every clinical surface carries citations — audio spans on scribe notes, FHIR resource ids on prior-auth packets, SOAP text spans on suggested codes.
Built for outpatient primary care, specialty clinics, and inpatient. Audio-span citations on every scribed section. Per-call AuthContext + Why trace on every write. Files stay in your cloud. Pricing is coverage-based, not consumption-based — so the always-on ambient scribe + continuous reconciliation surfaces don't create metering anxiety.
01. The clinical loop
Built for the way clinicians actually work.
Six tightly-coupled surfaces. Each cites the others. Each writes to FHIR. None of the screens require AI to be useful, but every screen is better because AI augments it without taking the pen.
- I. scribe
Ambient scribe
- getUserMedia → MediaRecorder → 16 kHz WAV → STT verbose_json with word-level timestamps.
- SOAP draft with character-span citations into the transcript. Hover §1 → highlight supporting words.
- Apply to encounter buffer in one click; post as FHIR Composition with section.extension carrying (transcript_id, span) — portable evidence outside Pollen8's UI.
pollenix.health · scribe - II. problems
Problem list & reconciliation
- Decay signal flags active conditions untouched > 180 days. Direct attack on problem-list rot.
- Scribe-proposed deltas (add / resolve / merge) with one-tap accept. Each delta cites the audio span.
- Trajectory data layer: onset → recorded → abatement. Encounter linkage in the next sprint.
pollenix.health · problems - III. meds
Medication reconciliation
- Continuous diff between MedicationRequest (prescribed) and MedicationStatement (patient-reported).
- Three columns: reported-only / prescribed-only / reconciled. One-tap promote or stop.
- Surescripts NewRx mTLS for non-controlled prescribing; EPCS-gated for schedules II–V.
pollenix.health · meds - IV. labs
Lab inbox + AI trend summary
- Abnormal-first triage from HL7 interpretation flags + reference-range fallback.
- AI trend narrative cites Observation ids: 'HbA1c rising from 7.1 to 8.4 over six months [obs-id-1, obs-id-2]'.
- Close-loop transaction: acknowledge + follow-up ServiceRequest + patient Communication letter under one Why trace.
pollenix.health · labs - V. plan
Care plan & chronic care
- CarePlan + Goal with LOINC-coded numeric targets and due dates.
- Auto-flip on matching lab result: when a new HbA1c lands ≤ target, the goal flips to achieved automatically.
- Best-effort reconcile triggers on every clinician lab acknowledge. Chronic-care closes on normal review.
pollenix.health · plan - VI. safety
Allergies & interaction check
- AllergyIntolerance writes with criticality + severity + reaction.
- Drug-allergy + drug-drug interaction check at every MedicationRequest authoring.
- Real licensed DDI (FDB / Lexicomp) ships in a follow-on for Joint Commission certification.
pollenix.health · safety
02. Revenue cycle
Full Mod-RCM, not a billing tab.
Eight surfaces close the submit-to-collect loop end-to-end: eligibility check before service, AI-scrubbed submission, X12 acknowledgment lifecycle, ERA ingest with denial worklist + AI appeal letters, payer-contract underpayment detection, patient OOP estimate at check-in, A/R ledger per patient, RCM analytics dashboard. The denial scrubber learns from your own historical ERAs — every payer rejection makes the next submission smarter.
- I. denials
ERA ingest & denial worklist
- X12 835 parser surfaces every CLP / CAS / SVC line. CARC + RARC codes classified into clinical / eligibility / coding / timely-filing / contractual / patient-responsibility categories.
- Worklist sorted by category, payer, age. KPI band shows open count, appealed count, total denied dollars.
- Every action chains to a Why trace — auditors can reconstruct who appealed what, when, with which evidence.
pollenix.health · denials - II. appeals
AI appeal letters
- LLM-drafted appeal letter per denial — category-specific argument template (medical necessity vs proof-of-timely-filing vs coding rationale).
- PHI-safe: model sees chart id + dates, not patient name. Static fallback template when no AI provider configured.
- Markdown editor for admin revision. Every revision tracked; audit signal shows AI-draft vs hand-edited.
pollenix.health · appeals - III. capture
AI charge capture
- Scans encounter notes + Observation + Procedure + MedicationAdministration + Condition for billable services the provider didn't code.
- Each suggestion carries CPT + ICD-10 + confidence + the exact evidence excerpt the model cited.
- Review queue routes to coder; accepted suggestions feed the 837 builder. Closes the 5–15% revenue leak from missed charges.
pollenix.health · capture - IV. scrub
Predictive scrubber
- Pre-submit checks: NCCI Column-1 / Column-2 bundling (full CMS quarterly bundle), prior-auth coverage, required-Dx pairs (screening colonoscopy → Z12.11).
- Historical risk model: queries your tenant's own denials by (payer, CPT). 25%+ rate warns, 50%+ blocks submission.
- Findings normalize into a single panel — severity, code, line index, fix hint.
pollenix.health · scrub - V. contracts
Contracts & underpayments
- Per-payer fee schedules with CPT × modifier pricing. CSV bulk paste — replace the whole schedule when the payer publishes a new rate sheet.
- Underpayment detector fires on every ERA ingest: paid_cents < expected_cents flags an alert with the dollar variance.
- Workflow: open → disputed → resolved or accepted_writeoff. Resolved variance rolls into RCM analytics as recovery.
pollenix.health · contracts - VI. oop
Patient OOP estimator
- Tell the patient at check-in what they owe — based on contracted allowable, deductible state, coinsurance %, copay.
- Per-line breakdown: deductible apply / coinsurance / copay / final patient share. Respects OOP-max cap.
- Worst-case fallback when benefits aren't on file. Every assumption surfaced explicitly so the front desk communicates honestly.
pollenix.health · oop - VII. auths
Prior-auth tracking + acks
- Operational record of active prior auths — units authorized vs used, effective dates, status (active / expired / exhausted / revoked).
- Scrubber consults the table before submission: over-utilized auth blocks at scrub time, not at adjudication.
- 277CA + 999 acknowledgment parsers close the submit-to-pay lifecycle — admins see accept / reject status before the 835 lands.
pollenix.health · auths - VIII. ledger
Patient ledger & analytics
- True double-entry A/R per patient: charge, insurance_payment, patient_payment, adjustment, writeoff, patient_responsibility. Balance = SUM.
- Idempotent ERA fan-out — same 835 ingest twice doesn't double-post. Manual entries audit-stamped with reviewer + reason.
- RCM analytics dashboard: first-pass rate, denial mix by payer + CARC, days in A/R, charge-capture lift, underpayment recovery, weekly denial trend.
pollenix.health · ledger
03. Operations & front desk
The non-clinical loop, same audit rails.
Scheduling, patient flow, recall, broadcast, supply, contact center — all under the same per-call AuthContext + Why trace spine as clinical writes. The AI voice agent that takes a refill at midnight uses the same identity-before-dispatch lock the e-prescribing module enforces.
Patient flow board
Real-time rooming status with wait timer. Front desk → MA → provider hand-off without paper. Productivity dashboards aggregate per-provider throughput.
AI voice contact center
Refill + scheduling + verification flows over a multi-provider voice adapter — pick your telephony vendor at deploy time. Identity-before-dispatch lock. DEA II–V controlled substances never auto-dispatched.
Dialogue workflow editor
Visual React Flow editor for voice + chat flows. Same runtime serves the contact center agent. AI flow generation from a prompt — `"build me a flu-shot recall call"` produces an editable workflow.
Recall + broadcast
Care-gap recall panel surfaces patients due for screening / chronic follow-up. Broadcast messaging (email + SMS) by cohort with HIPAA-safe templates.
Supply inventory
Inhouse supply items + movements ledger. Par-level alerts for clinical consumables. Optional auto-reorder hook on low stock.
04. Patient experience
Portal, telehealth, previsit — first-class.
Patient-facing surfaces share the platform's BAA-grade audit and CSRF posture. Portal access is OTP-first — patients don't maintain a password. Telehealth recordings attach to the FHIR Encounter as DocumentReferences, citation-ready.
Patient portal
OTP-based access, secure messaging to the practice, intake forms, billing + statements, payment via Stripe Connect. No password to forget on the patient side.
Telehealth video
WebRTC video room with JWT access tokens. Provider + patient join from the portal; the recording attaches to the FHIR Encounter as a DocumentReference.
Network previsit
Eligibility check + intake forms + insurance card capture before the visit lands. Patient walks in already verified; staff time savings are immediate.
DirectTrust messaging
Clinician-to-clinician S/MIME secure email with multipart MIME + detached PKCS#7 signatures. Spec-conformant, not a gateway service.
05. Patient acquisition & reputation
The growth surface, not just the chart.
Public booking widget, lead-capture form, review aggregation, post-visit NPS, automated review requests, and a slug-addressable public practice page — first-class surfaces under the same audit spine as the clinical loop. No third-party engagement bolt-on, no separate billing relationship.
Online booking widget
Embeddable booking page at /book/{practice-slug}. Anonymous patients pick a slot from your availability templates, submit demographics + insurance, and land in a confirm-or-reject queue — no auth surface exposed to the public internet, no real Appointment materialises until staff confirms.
Lead capture
Public new-patient inquiry form with channel attribution (search / ad / referral / walk-in / unknown). Lands in a status-tracked worklist — new → contacted → converted or discarded — with IP hash for spam triage.
Reputation aggregation
Daily pull from Google Places, with Yelp + Healthgrades on the roadmap. Reviews dedup across re-syncs; admin-set status (responded / flagged / hidden) survives re-fetch. Partial index on rating ≤ 3 so detractors surface first.
Review-request automation
Post-encounter SMS/email asking the patient to leave a review with a deep-link to the platform you choose. Audit log of sent → clicked → completed so you can measure conversion per channel.
NPS / post-visit survey
Internal 0-10 + free-text survey separate from public reviews. Single-use submission token sent to the patient; promoter / passive / detractor split + average + trend in the staff dashboard.
Public practice profile
Slug-addressable public page rendering display name, specialty, address, phone, hours, about. Booking and lead-capture toggle independently so a practice can open one before the other.
06. AI moats
Citations are a FHIR primitive, not a UX flourish.
The audio span the clinician dictated. The FHIR resource id the model read. The SOAP text span that supports each suggested code. Each lives on a FHIR resource extension — verifiable outside our UI, by any downstream consumer.
Chart Review Agent
30-second summary of the patient before the visit. Active problems, medication concerns, abnormal trends, open loops — each citing the FHIR resource ids the model drew from.
Prior-Auth Drafter
Drafts a PA packet for any MedicationRequest or ServiceRequest. Each evidence claim cites a resource_ref. Completeness score + missing-fields list so the biller knows what to chase before submission.
Denial Scrubber
Pre-submit denial probability + gap list against payer-rule heuristics (medical necessity, frequency limits, modifiers, PA on file, duplicates). Each gap shows field / issue / fix / severity.
Code Suggester at sign-off
E/M level + ICD-10 dx + CPT procedure codes from the SOAP body + active problems. Each code rationale links back to the supporting SOAP text span — pairs with audio-span citations for the full audio → SOAP → code chain.
07. Wires in, wires out
Every healthcare integration that matters, real not stubbed.
FHIR R4 bulk export to migrate a chart out of Epic / Cerner / Athena. HL7 v2 MLLP to receive lab results from the analyzer. X12 270/271 to check eligibility. X12 837P/835 to bill. Surescripts for prescriptions. DirectTrust for secure clinician-to-clinician email. All wired against real spec — not vaporware.
FHIR R4
US Core profiles + Bulk Export ($export) for Epic / Cerner / Athena migration.
HL7 v2 MLLP
Inbound ORU^R01 (lab) + ADT^A01/A04/A08 (admit / register / update).
Surescripts NewRx
mTLS prescription send. EPCS-gated for controlled substances.
X12 270/271
Eligibility check before service. Real-time round-trip with the clearinghouse.
X12 837P/I
Claim encode for professional + institutional billing. Frequency-7 corrected resubmission supported.
X12 835
ERA parse — auto-creates adjudication, denials, underpayment alerts, ledger entries.
X12 277CA + 999
Acknowledgment parsing — close the submit-to-pay lifecycle before the 835 lands.
CMS NCCI
Quarterly Practitioner PTP edits bundle loader — admin uploads, scrubber consults globally.
DirectTrust
Multipart MIME + detached PKCS#7 S/MIME for clinician-to-clinician secure email.
WADO-RS DICOM
Imaging study list + frame fetch via rendered/jpeg endpoint.
Telehealth
WebRTC video room with JWT access tokens. Recording attaches to the FHIR Encounter as a DocumentReference.
AI voice contact center
Multi-provider adapter — pick your telephony vendor at deploy time. Refill + scheduling + identity-verify flows.
Stripe Connect
Per-tenant Connect account onboarding + webhook signature verification + Invoice flip on payment.
CDS Hooks
Decision-support hook surface for add-ons + external triggers.
08. Audit & compliance
Designed around the audit, not bolted onto it.
Every clinical surface writes through one audited path. The per-call AuthContext + Why trace architecture isn't a marketing line — it's what makes ONC integrity criteria + EPCS DEA audits tractable in the first place.
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Per-call AuthContext capability tokens (≤ 30 s TTL, single-use, audit-logged).
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Why trace on every write — purpose_code (TREAT / BILLING / PAYMENT), subject_id, parent_trace_id chained across multi-step transactions.
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Separate KMS key + separate audit table from non-Health Pollen8 surfaces.
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BAA available. Files stay in the customer's cloud — Pollen8 is deployable, not SaaS.
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ONC §170.315 criteria mapped surface-by-surface; cert in flight with an ACB.
Pollen8 MR
Deploy where your data lives.
Pollen8 is sold through AWS and Azure Marketplaces — single SKU, tenant-scoped deploy in your account. Files stay in your cloud. BAA on signature. Coverage-based pricing.