DeskGate · Healthcare Execution Schematic v3.4

The gap is real.
This is how we close it.

Existing core platforms decide and orchestrate. Residual work still leaks into browser payer portals, attachments, status phone trees, and appeals packets. DeskGate stages that leftover work inside the operator’s own session. AI plans. Our multi-rail access mesh retrieves locked policy evidence when needed. The human remains the non-negotiable approval gate.

Layer 0 · Already in place Customer Systems & Core Platforms

🏛️ EHR · RCM · PA/UM Decision Engines

They already handle patient chart records, medical necessity guidelines, eligibility checks, billing routing, and general orchestration. They do not finish the residual last-mile clicks and document transfers that lack a direct clearinghouse API.

Epic / athenahealth Availity / Waystar eviCore / Carelon Decision already rendered
▼ Residual Work Leaks Here ▼
The Residual Gap Where software reaches its API boundary

⚠️ Un-automated clicks, attachments, & phone trees

Regional payer web portals without APIs, multi-PDF packet merges, missing clinical evidence notes, IVR telephony status checks, and appeal packet re-submissions. Today, this work is pushed onto overworked internal staff or outsourced offshore.

Payer portal click-paths Chart attachment merges Status phone chase Appeals packet forge
▼ DeskGate 4-Layer Engine Closes The Gap ▼
L1 · Web Access & Reach Multi-Rail: Bright Data · Exa · Registries

🌐 Reach Locked Policy Surfaces

Web Unlocker, SERP, formulary coverage portals, and semantic policy extraction when an insurer or medical evidence source is locked, geofenced, or bot-blocked. This is robust access infrastructure—not care decisioning.

Web Unlocker API Formulary Rule Extract Automated Failover
L2 · Autonomous Ops Grok / Gemini + Shadow SRE

🧠 Map Context & Stage Steps

Analyzes the active screen and medical records, plans the exact sequence of residual form inputs, drafts justification narratives, and flags anomalies. It does not submit irreversible actions on its own.

Screen Understanding Draft Field Payloads Exception Detection
▼ Sense Environment & Run Client-Side ▼
L3 · Physical & Digital Embodiment Camera · Viewport · Screen Bind

👁️ See What the Operator Sees

Optical character recognition, active DOM viewport mapping, and document scanning ensure that actions are bound directly to the live page state rather than blind heuristic guesses.

Optic Verification Insurance Card OCR Viewport Binding
L4 · Local Last-Mile Runtime embed.js + overlay.html

⚡ Execute in Operator Session

Everything stays local to the operator's authenticated browser. DOM micro-actions, WebRTC voice agent assist, case memory, and PDF dossier foundry forge live without shipping credentials offsite.

In-DOM RPA WebRTC Voice Assist PDF Foundry
🛑 Irreversible Actions Stop Here 🛑
Non-Negotiable Human Gate 70–90% Staged · 10–30% Exceptions

🛡️ Human Operator Remains in Command

All mundane keystrokes, document lookups, and form staging are prepared automatically. Submit buttons, appeal filings, prescription verifications, and irreversible clicks await explicit human confirmation. Zero unauthorized autonomous filings.

1-Click Human Approval Clinical Exception Route Full Operator Audit Log
▼ Cryptographic Proof Generated ▼
Audit Provenance · REA v1.2 Residual Evidence Artifact

📜 Cryptographically Verified Audit Trail

Every completed case generates a tamper-evident, SHA-256 hashed dossier detailing what was scraped, what was drafted, the operator's approval timestamp, and the exact portal response payload.

BAA-ready Zero-retention mode available Deterministic Trace

📊 Responsibility Matrix (Who Does What)

L1 Access Engine

Multi-Rail
  • Unblocks rate-limited or geofenced policy portals
  • Automated failover across web access rails
  • Authorized data extraction pipeline
  • Never renders medical determinations

AI Core (L2)

Grok / Gemini
  • Reads unstructured medical charts & cards
  • Plans the residual portal form steps
  • Generates step-therapy exception notes
  • Flags ambiguous policy rules to human

Local Last-Mile (L4)

In-Browser
  • Injects embed.js into active tabs
  • Executes DOM clicks under user credentials
  • WebRTC telephony & IVR transcription
  • Forges PDF evidence dossiers on the fly

Human Operator

Final Authority
  • Reviews staged fields in 10 seconds
  • Presses final Submit / Confirm button
  • Decides clinical nuance & edge cases
  • Owns full regulatory accountability

⚡ Residual Workload Split & ROI Model (Illustrative)

Estimate potential operational hours and labor efficiency gains when staging 70–90% of repetitive residual steps.

82% Staged by Runtime
18% Human Exception / Approval
394 hrs
Est. Operator Hours Staged / Mo
$13,790
Illustrative Monthly Labor Capacity
*Illustrative benchmark model based on a $35/hr burdened administrative rate and ~80% staged step automation. Actual time savings and throughput velocity are measured and verified during the 14-day frozen-cohort pilot ledger.

🎯 Not a Full Platform Replacement

DeskGate does not replace your billing platform, your EHR, or your clinical decision engine.

It connects underneath existing systems to complete the residual 15–30% of work that currently requires human staff to copy-paste between windows, wait on hold, or navigate legacy payer portals.

PROVENANCE ASSURANCE
Every execution produces an immutable REA v1.2 record with client-side Zero-Retention Mode (ZRM) active for HIPAA-regulated workflows.

💻 Drop-In Runtime Integration

One script tag mounts the sovereign client-side overlay onto your portal without refactoring backend databases.

<!-- DeskGate Sovereign Client-Side Execution Layer --> <script src="https://deskgate.app/embed.js" data-tenant-id="healthadmin-prod" data-surface="prior-auth" data-human-gate="strict-approval" defer></script> <!-- 1. Overlay loads directly inside operator browser session --> <!-- 2. Multi-rail access mesh unlocks external payer & policy evidence --> <!-- 3. Human must click [Confirm & Transmit] to execute --> <!-- 4. Signed REA v1.2 audit dossier generated upon submission -->