DeskGate
BAA active · Vertex AI · 28 Sep 2026
Product note (29 Oct 2026): DeskGate, Inc. sells Rebuttal Studio: it runs in the browser, nothing to install, $98 per PC per month (CHF 98.– in Switzerland). This page describes the Operator Extension 2.6.8 runtime, which stays available to existing installs.
Deployment readiness · Pilot governance
Healthcare AI pilots tend to fail on organizational questions: a baseline nobody agreed, a sponsor who drifts away, a clinical boundary nobody wrote down. These four tools settle those questions before day 1 of a Schedule M measurement. Every figure in them is the desk's own.
The free month needs none of this. Every practice gets 30 days free on all payer portals, with a pre-period baseline and a blinded ledger DeskGate may publish. A practice manager, clinic owner, or billing director starts the trial, accepts our BAA (or Swiss Schedule CH AVV) before any live patient data, installs the extension and starts. The gate and charter below are for subscribing desks that want a frozen-cohort measurement.
12Readiness conditions confirmed before a subscribing desk's key is issued
30 daysFree Schedule M measurement on the desk's own portals, against its own baseline
0Autonomous submits. A single one stops the measurement.
Four tools
Work through them in order. The gate decides whether a desk is ready, the charter freezes what will be measured, the worksheet counts what the product costs the desk, and the spear states what DeskGate will never do. Each one can be taken away as Markdown.
Tool 1 · Change readiness
On a subscription, the desk key is not issued until all 12 conditions are confirmed. This is not paperwork for its own sake. It keeps the 30-day measurement safe from a sponsor walking away or a contaminated queue.
Tool 2 · Schedule M
Frozen before day 1. The charter is completed and signed before staging starts. It records the desk's own pre-period baseline, locks the cohort, pre-registers exceptions and defines coordinator-days, so the day-30 ledger cannot be challenged after the fact. The desk fills in every figure; DeskGate supplies none of them and promises no target. Use Edit fields to adapt the wording, then Copy as Markdown.
1. Executive sponsor (practice or revenue cycle)
Signature and date
2. Operating lead (appeals desk)
Signature and date
3. DeskGate, Inc.
Hans Johannes Schulte · Systems Architect
Tool 3 · Full-cost accounting
Healthcare buyers distrust vendor ROI models because they leave out the internal cost of adopting the tool. This worksheet counts compliance review, coordinator onboarding and Time-at-Gate (the coordinator's review of each staged packet) as costs. Every figure is the desk's own, written before day 1 or measured during the 30 days. DeskGate supplies none of them.
| Worksheet line | What goes in | Who supplies it, and how it is treated |
|---|---|---|
| Target workflow | Denial appeals and non-API prior authorizations on the payer portals the desk works | The desk names the portals it measures; all portals are licensed |
| Current annual labor cost | Coordinators on the desk × the desk's own loaded cost | The desk's figure; DeskGate does not supply it |
| Current baseline | Appeals completed per coordinator-day over a stated pre-period | The desk's own records, written before day 1 |
| Software price | One license: $98/month or $980/yr per active PC (CHF 98.–/Mt. · CHF 980.–/Jahr exkl. MWST in Switzerland), every payer. One more license per PC working at the same time; third-party billing agencies get an Enterprise agreement. Zero case metering. | Every practice: 30 days free on all portals. After day 30, the practice cancels or continues. |
| Implementation fee | $0 (CHF 0.–), with onboarding included. | Within practice-owner, practice-manager, or billing-director signing authority |
| Governance and BAA / AVV cost | Review of the one-page BAA (US) or Schedule CH AVV (Switzerland) and Schedule M | One-time internal review, priced at the desk's own hours |
| Coordinator training time | One live session plus the synthetic showcase tests | Done before the first live case |
| Hidden workflow burden (Time-at-Gate)Counted as a cost | Review time per staged packet, measured during the 30 days | A new task the product creates. Counted as a cost against any gain, never assumed away. |
| Net capacity yieldAfter day 30 | Coordinator-days avoided per 1,000 cases, computed from the desk's own day-30 numbers | Reported only after day 30. The desk applies its own loaded cost; DeskGate states no dollar figure. |
| Gain-erasing risks | Payer portal downtime, unannounced interface overhauls | A redesigned form is re-read like a new one; a box DeskGate cannot match is left for the coordinator. Autonomous submits stay at 0. |
Tool 4 · Clinical scope boundary
To answer CMO and CMIO questions about malpractice exposure, we state our boundary in clinical vocabulary. DeskGate works only on the shaft and mid-shaft, the administrative work, and stays off the tip, where treatment decisions are made.
Diagnosis, prescribing, patient triage and decisions about clinical efficacy.
DeskGate never entersMedical-necessity evaluation, guideline interpretation and drafting clinical documentation.
Clinicians and the EHR decideDrafting the appeal by quoting facts already on screen in the chart, marking anything the chart does not say as [MISS], staging payer portal boxes and flagging empty upload boxes. Then it stops for the coordinator.
DeskGate drafting and stagingWorking inside the coordinator's own logged-in session, typing staged values into portal boxes and hashing the payer reference (SHA-256) for the pilot ledger.
DeskGate runtimeClosing governance question
“Have we earned the right to move closer to the patient, or are we still learning on the shaft?”
DeskGate's answer: we stay on the shaft by design. We do not practice medicine. We prepare the paperwork, and the coordinator submits it.
Next step
Start with the free month, or bring the charter to a subscription conversation. Either way, tell us the portals and the queue, and we will walk through it with your practice manager or billing director.
Schedules S, I, M and CH are part of the signed order. This page is a working aid; the signed order and the business associate / data processing agreement control. Chart notes and member IDs are not written to DeskGate databases; the pilot ledger stores a SHA-256 of the payer reference; screen reads go to Vertex AI under the Google Cloud BAA executed 28 September 2026 (or, in Switzerland, are processed in memory in Zürich under the AVV 3.0 with standard contractual clauses).