DeskGate · in-browser residual runtime

We stage the portal work
your EHR cannot finish.
Your coordinator still hits Submit.

DeskGate mounts in the coordinator's browser and stages prior authorizations, attachments, and status checks on Availity and commercial payer portals. No hospital IT refactor. Irreversible submit stays with the human operator.

Start a 14-day measurement
In-session browser runtime · no vendor payer credential · 1-click human approval before Submit
SIMULATED PORTAL · BCBS PRIOR AUTH OPERATOR ACTIVE
STATUS: READY TO STAGE STAGED IN 0.0s

Synthetic walkthrough. No live payer submission. Submit stays behind the human gate.

Why this is not cloud RPA

Cloud bots and unattended agents stop at the same wall.

Hospital VPNs, MFA, and payer bot management block headless browsers. UI redesigns break XPath bots. Compliance rejects unattended submit. DeskGate runs inside the already-authenticated session and stops before the irreversible click.

In-session embed.js

Uses the coordinator’s live login

The runtime mounts in the operator browser and inherits SSO, VPN, and 2FA already completed. No remote farm trying to impersonate the desk.

Visual grounding UI drift

Sees the screen, not just the XPath

Payer portals change markup. The stager binds to what is on screen plus the DOM, so a redesigned button does not take the whole lane down.

Human gate Operator in command

Stages the form. Does not own Submit.

Repetitive fields can be staged in seconds. The irreversible payer click stays with the coordinator. Legal accountability does not move to an unattended agent.

Local evidence Zero-retention mode

Audit packet without a PHI warehouse

Case work can stay in workstation RAM under zero-retention client mode. A hashed evidence packet records what was staged and who approved it.

Where portal minutes leak after the EHR stops

How it breaks today

Staff log into 15+ payer portals and copy chart notes field by field because there is no uniform API for that last mile.

How DeskGate stages it

The runtime reads the active portal and available case context, stages the fields, and stops at Submit for human sign-off.

What a first desk actually does

No platform rip-and-replace. One payer family. One frozen cohort. Minutes measured, not promised.

1

Mount under the live portal

Drop the client-side runtime onto the coordinator workflow already in use. No EHR rebuild. No new system of record.

Zero backend refactor
2

Measure one lane for 14 days

Freeze a cohort on one portal family. Record handling minutes, attachment completeness, and human-gate rate. Then decide whether to keep the seat.

Minutes measured, not promised
The 2027 deadline

CMS-0057-F automates the structured half. We built for the other half.

Impacted payers must run a FHIR prior-authorization API by 1 January 2027. Self-funded employer plans under ERISA are exempt. Drug prior authorization is excluded. Requests that go to clinical review still need documentation assembled by hand. And through the transition, coordinators work a mixed book — some payers structured, most not — which costs more than a uniformly manual desk.

Read the full position, including the case against us →
Model routing

The model that reads the screen has to be one a BAA can cover.

Staging a payer form means reading a screen that can contain patient data. Which model receives that frame is a contractual question, not a preference. Most developer-tier model APIs are explicitly not covered for protected health information, so DeskGate routes PHI-bearing calls to a provider that will sign a Business Associate Agreement, and refuses to fall back to one that will not.

BAA-eligible route
Anthropic Claude API

Anthropic will sign a BAA for the Claude API. Vision and case reasoning route here when PHI_MODE is on. Claude on AWS Bedrock and Gemini on Vertex AI are equivalent covered surfaces.

Prototyping only
Developer-tier API keys

A Gemini key from AI Studio is not BAA-eligible — only Vertex AI under the Google Cloud BAA is. Fine for synthetic demos. Never the path for a live case.

Whose key
Bring your own

The desk holds its own model keys and its own vendor agreements. We never take custody of a payer credential. Voice runs on ElevenLabs with a signed BAA and zero-retention mode.

What this does not mean
Routing to a BAA-eligible model does not make DeskGate HIPAA compliant, and we do not claim it does. Whenever this software touches PHI for a covered entity, DeskGate is itself a business associate: that requires our own BAA with the practice, a risk analysis, and documented policies. Vendor agreements cover vendors. They are a prerequisite, not a substitute. The full position, including what is still open →
🔒 BAA-ready path: zero-retention client mode
🛡️ Human gate: confirmation before submission
📜 Evidence packet: hashed provenance log
🌐 Sovereign runtime: no offshore HITL desk