heme gives each physician an AI that drafts the note from the room, codes it from the documentation behind it, and answers denials with the payer's own policy. You keep the exam, the judgment, and the signature. Hospital-grade FHIR, SMART-on-FHIR, and X12 EDI underneath, priced for a practice that owns itself.
Visit audio is encrypted in transit, transcribed on heme-operated GPUs, never stored, never used to train · chart-grounded appeals, never fabricated · HIPAA-aligned audit captured at the database layer.
So the hours go back to patients, not paperwork.
Record the visit. heme transcribes it on its own GPUs, with no third-party ASR vendor, and drafts a clean, free-form note on one canvas. Audio is encrypted in transit, processed in memory, and never retained. You read and sign.
heme reads the signed note and stages ICD-10, CPT, and E/M, each with documented rationale. Defensible, optimal, and matched to what the visit documents. You approve before anything bills.
When a payer denies, heme drafts the appeal from your own chart and the payer's own policy, and blocks anything the record doesn't support. Appeals overturn most denials; almost none ever get filed. heme files them.
Before your first patient, heme has read the overnight denials, drafted an appeal that cites each payer's own coverage policy, and queued them for one signature between patients. Every chart on the schedule already carries the context the visit needs. By the end of clinic, time on prior auth, appeals, and coding is near zero. You recovered hours.
The same FHIR R4, SMART-on-FHIR, Bulk Data, US Core, and X12 EDI the hospital across the street runs, so your chart and theirs speak without re-keying. Same standards. Same data. None of the enterprise tax.
A scheduling app. An EHR. A billing service. A FHIR gateway. An audit log. Each on its own invoice. None on the standards the hospital across the street is built on, so the patient who sees you Tuesday and the cardiologist Thursday lives in two charts that never meet.
Scheduling, charting, billing, one app. FHIR R4, SMART-on-FHIR, Bulk Data, the same standards the hospital across the street is built on. Your notes flow into their chart. Their labs flow into yours. Same patient, both practices, finally on the same page.
The schedule grid is the chart's front door. Click a slot, walk in. The slot becomes a snapshot, the snapshot becomes a note, the note becomes a charge, no tab dance, no second app.
Dot phrases and reusable shortcuts on one free-form canvas, no SOAP boxes to tab between. Type it, or dictate and let the ambient scribe write it. Ctrl/⌘+N opens a fresh note inside the chart you were already in; Ctrl/⌘+Enter signs and locks. The Coding Gladiator reads the note before it leaves your screen and pre-stages the codes for the claim.
Problems, medications, allergies, vitals, recent encounters, one screen, no tabs. The allergy chip is the one place in the entire product where status is communicated by color, and even then it earns its single navy pill the same way an Epic banner does.
Results from the lab, messages from patients, refill requests, faxed documents. Folders for each, routing to the clinician on the chart. Status is read or unread, by typographic weight, not by a colored badge.
You finish the note on one free-form canvas, type it or dictate it; Ctrl/⌘+Enter signs the encounter. Gladiator reads the note and flags ICD-10, CPT, and E/M level with a documentation-gap check, in line, before the chart closes.
The charge picks up the prior-auth number, the claim builder lays out the X12 envelope, validators run NPI and taxonomy and payer-specific quirks, the batch ships to your clearinghouse on the next cycle.
The payer sends the 835 back. Payments post to the right charges automatically, paid claims close, partial pays update the balance, and any denial routes straight to the Gladiator, which has the appeal drafted before you have seen it. No manual posting.
ICD-10 · CPT · E/M at sign · documentation-gap check · chart-grounded CARC appeals
ICD-10, CPT, and E/M picked at sign with accurate, fully-documented rationale persisted to the encounter: optimal, appropriate coding, each code matched to the documentation behind it. A documentation-gap check runs before the chart closes. Utilization-management systems deny appropriate, documented care at scale, and most denials are overturned once the record is presented, so the moment a CARC denial lands, the Gladiator drafts the appeal from the original note and the coding rationale, behind a chart-grounding gate that allows only what the record supports. Every denial feeds back into the rule set, so the documentation a payer requires is in place before the next request goes out.
X12 278 inquiry + response · auth auto-stamped on the 837P · no-auth submission gate
The 278 inquiry goes out the moment a CPT trips a needs-auth rule. The 278 response stamps the auth number onto the 837P automatically, no claim leaves without it. If a denial lands, the appeal drafts itself from the chart and the payer's own policy.
835 allocator · PLB reversals · pro-rated WO recoupment · CARC 197/198 learning
Zoom in on the posting engine: the allocator walks each 835 line, applies payments and adjustments to the exact charge, honors PLB reversals, and pro-rates a WO PLB when the recoupment is less than the prior payment. CARC 197/198 denials feed the learned rule set. The math closes to the cent, every batch.
Patient-responsibility statements · Stripe checkout link · emailed dunning cadence
When the 835 lands and the patient owes a residual balance, heme drafts a statement, emails it from your practice, and embeds a hosted checkout link backed by Stripe. The payment posts back to the same charge automatically, no portal, no second-system reconciliation.
Charge → claim → payment double-entry ledger · audit-linked · drill to any posting
Every dollar lives on a single ledger: charge created at sign, claim built, payments posted (insurance via 835, patient via Stripe), adjustments and reversals applied with audit-grade provenance. AR aging is a query, not a report you wait for.
Your patient sees the cardiologist at the hospital on Thursday. Her workup, labs, imaging, and consult note, already shaped as FHIR. heme reads them on Monday morning, before she walks in. Your visit ships back the same way: a FHIR bundle the hospital's Epic accepts without re-keying.
SMART-on-FHIR backend services · RS256 + JWKS · RFC 7591 DCR · per-route scopes
SMART-on-FHIR backend services. Asymmetric RS256 keys, a JWKS endpoint heme exposes for verification, RFC 7591 dynamic client registration, and per-route scope gates. No shared secrets, no IP allowlists, no calling somebody's ops team to whitelist your machine.
Productivity · AR-aging · panel · Gladiator ROI, live off the ledger, no overnight batch
Productivity by clinician. AR aging by bucket. Active panel by clinician. Gladiator ROI, dollars recovered through coding and appeals against the baseline. No batch jobs, no overnight refresh; the numbers come from the same ledger that just posted the last payment.
Per-practice IRIS namespace · physical data isolation · no shared tables (ADR-001)
heme runs on InterSystems IRIS, and every practice gets its own namespace, its own database, its own globals, its own indices. Cross-practice access isn't a permission, it's a physical impossibility. The system namespace holds the practice catalog; the rest never see each other.
Repository-layer audit · append-only · who / what / when on every PHI touch
The audit log lives at the storage layer, not the route layer. Every persistence call records subject, actor, action, outcome, and IP, and the FHIR Provenance resource carries the same chain into anything heme exports. HIPAA-aligned by construction.
Stripe checkout → namespace provisioning → admin user → welcome email, automated
A practice owner fills the signup form, runs Stripe Checkout, and four things happen automatically: an IRIS namespace is provisioned in the database engine, schema migrations run against it, an admin user is created with a temporary password, and the welcome email goes out. No operator SSH, no implementation contract.
Operator console · practices · Stripe events · seat usage · system.admin-gated
The system-admin surface lists every practice with its subscription status, seat usage, and onboarding state. Stripe events flow into an audit-grade event log. Failed onboardings retry from the UI. Seat usage rolls up to a single MRR number, the operator sees the whole business from one screen.
1 clinician
per clinician / month, billed annually
2-10 clinicians
per clinician / month, billed annually
11+ clinicians
Custom, talk to us
Per active clinician seat, billed annually. No setup fee, and never a percentage of your collections.
We're onboarding independent practices in waves. Tell us a little about you and we'll reach out as access opens, with a guided setup of your own isolated workspace.