DeskGate by DeskGate, Inc.
Delaware C-Corp 🏥 Healthcare Desk ⚙ How We Execute 🛡 Position 💼 Access & Pilot ✉ Contact
EXECUTION AFTER DECISION · HUMAN APPROVAL GATE · SYNTHETIC DEMO

After the platform decides,
DeskGate executes the residual

The intelligence layer already knows what should happen. Operators still spend residual minutes on authenticated screens, DOM workflows, verification calls, attachments, and appeal drafts. DeskGate runs those approved actions, preserves case context, and generates an audit dossier — pausing before irreversible steps so the operator remains the approval gate.

Show the residual minutes. Measure one workflow. Operator stays the decision-maker.

Built for one buyer:
Independent clinics Specialty PA desks RCM & billing firms MSO / IPA operations Home health agencies
Clinical Assistant
Clinical-grade operator presence
ARCHITECTURE ANCHORS · HOW WE OPERATE ACROSS PAYER PORTALS 1–2 DESIGN-PARTNER DESKS OPEN

1. Cross-Tab Session Bridge

Operates inside the coordinator's authenticated browser session across tabs, inheriting active 2FA, SSO, and VPN logins without cloud bot-blocking.

2. VLM Coordinate Grounding

Uses multimodal visual reasoning to ground clicks on rendered viewports, immune to frontend CSS/HTML layout redesigns on payer sites.

3. The Coordinator Remains the Filing Actor

Mandatory 1-click human confirmation before irreversible submit. Your licensed coordinators remain the filing entity of record.

4. 100% Mapping Credit

The first 2 design-partner desks receive 100% of their $15k–$25k implementation mapping fee credited toward Year 1 subscription on annual conversion.

Reference Workstation · Synthetic Prior-Auth Path OPERATOR GATE · NO LIVE SUBMISSION
Synthetic Wegovy 0.25 mg · BCBS commercial PPO · intake → policy → necessity → telephony notes → appeal → dossier
Synthetic data only. No clinical decision is made. Paths are labeled [LIVE] or [SIM]. The operator remains the approval gate before any irreversible action.
Status: Workstation Ready
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Not started
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Benefit Verification & Patient Intake (Optic Stream)
Active
OPTIC FEED STANDBY
📷 Patient & Document Optic Camera Feed
Enable camera to see patient or hold up physical insurance card / medical documents for real-time OCR extraction
2
Prior Authorization & Medical Necessity
Waiting
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Submission, Telephony Verifications & Live Tracking
Waiting
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Denial Risk & Clinical Appeal Foundry
Waiting
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Final Case Dossier & Handoff
Waiting
Engineered for Enterprise Healthcare Automation Platforms
Develop Health & Latent

Motor cortex layer for specialty prior-auth forms, complex step-therapy rules, and clinical rationale compilation.

Candid Health & RCM

Touchless exception handling for portal claims, eligibility disputes, and non-API payer web interactions.

Telephony In + Out

Outbound & inbound phone verifications for eligibility, PA status, and benefits confirmation with shared case memory.

Penguin AI & Cohere

Sub-400 ms WebRTC voice + DOM puppeteering for AI Workers conducting payer phone follow-ups and portal submissions.

Sovereign & BYOK

Zero-retention capable, WeasyPrint PDF foundry, and credential isolation — the desk holds its own model keys and vendor agreements. BAA-eligible model routing; BAA not yet executed.

OPERATOR ARCHITECTURE & SAFE DILIGENCE FAQ

Practical Diligence Notes for Operators & Investors

Key questions answered on first sight before connecting DeskGate under an existing PA or RCM stack.

✦ How do we reach external payer portals if mounted in an EHR?
DeskGate operates via an in-browser runtime (`embed.js`) coupled with a lightweight operator extension bridge. Because it executes within the coordinator's local browser, it inherits their active SSO, Duo 2FA, and hospital VPN connections across tabs—natively bypassing Cloudflare/Akamai bot-blocks that kill remote cloud scrapers.
✦ What happens as foundation-model browser control improves?
It helps us. We are a consumer of those models, not a competitor to them — DeskGate routes its vision and reasoning calls to Claude, and better grounding makes our staging cheaper and more reliable. What we add on top is the healthcare-specific part: payer SOP mapping, exception routing per portal family, the human gate, and the REA audit record. We do not claim a foundation-model lab could not build this. We claim the accumulated portal behaviour from live desks is what is hard to copy, and that is earned rather than architected.
✦ What is the exact Win-Win for the first 1–2 reference desks?
We structure our first 2 reference desks with 100% mapping fee credit: the $15,000–$25,000 implementation fee is completely credited toward their Year 1 annual subscription upon conversion. They get their #1 worst payer portal automated, backlog cleared, and receive an empirical 14-day ledger proving exact minutes saved.
✦ Where does clinical and legal accountability sit?
With your licensed coordinator, and it does not move. We do not sell unattended autonomous filing. The runtime stages repetitive data entry, then halts before the irreversible submit click; a 1-click confirmation by the named coordinator is required to proceed. They remain the filing entity of record and can refuse. We make no clinical or medical-necessity determination. This reduces a specific class of risk — it does not eliminate liability, and no software can.
✦ Where does ePHI live? (HIPAA & Zero-Retention Mode)
Case data is held in volatile workstation RAM during the active session and is not persisted to a DeskGate database. Each completed case compiles a SHA-256 hashed REA v1.2 audit record for the clinic's own files — a fingerprint, not a copy of the packet.

One path does leave the browser and you should know about it: reading the payer screen sends a frame to a model provider, and that frame can contain PHI. We route those calls to a provider that will sign a BAA (Anthropic's Claude API; Claude on AWS Bedrock and Gemini on Vertex AI are equivalent), and the runtime refuses to fall back to a non-covered provider when PHI mode is on. A developer-tier Gemini key from AI Studio is not BAA-eligible and is for synthetic demos only.

To be plain: this is a data-minimising design, not a compliance certification. Whenever DeskGate touches PHI for a covered entity it is itself a business associate, which requires our own BAA with the practice, a risk analysis, and documented policies. Vendor agreements cover vendors; they are a prerequisite, not a substitute.
✦ What is live versus simulated in this demonstration?
Form fills and clinical rationale drafting are simulated for demonstration speed. Live policy lookups via Bright Data, WeasyPrint PDF dossier forging, and outbound Twilio telephony verification calls execute live whenever credentials are provided. All execution paths are labeled in the UI.

DeskGate, Inc. · Delaware C-Corporation · Sovereign Last-Mile Execution for Healthcare · Healthcare Desk · How We Execute · Position & defensibility · Master Terms