Active Patients
—
▲ 4.2% vs last month
Telehealth Today
—
▲ 3 live now
AI Tasks Today
—
▲ 6 agents active
FHIR Syncs Today
—
▲ All systems live
Patient Visits — Last 7 DaysView report →
In-person
164
Telehealth
68
New patients
23
No-shows
8
Diagnosis MixDetails →
Cardiology40%
Primary Care20%
Orthopedics13%
Neurology11%
Other16%
Today's ScheduleFull schedule →
9:00
Maria Gonzalez
Cardiology · Dr. Park
9:30
James Wilson
Telehealth · Dr. Chen
10:00
Priya Sharma
Lab Results · Dr. Harper
10:45
Robert Kim
Telehealth · New Patient
11:15
Susan Okafor
Physical · Dr. Chen
AI Agent ActivityView all →
AI
Triage Agent flagged Priya Sharma — elevated BP + headache
2 min ago
AI
FHIR Sync pulled 14 new lab results from Quest Diagnostics
7 min ago
AI
Prior Auth Agent submitted authorization for Maria Gonzalez
22 min ago
AI
HL7 ADT message received — Robert Kim admitted to Ward 3B
38 min ago
AI
PACS new MRI study linked to Priya Sharma #PT-00502
1 hr ago
| Patient | DOB / Age | Department | Provider | Last Visit | Visit Type | Status | Actions |
|---|
Showing 1–6 of 248 patients
1
2
3
…
42
April 7 – 13, 2026
MON
7
TUE
8
WED
9
THU
10
FRI
11
SAT
12
SUN
13
■ Cardiology
■ Primary Care
■ Orthopedics
■ Neurology
■ Telehealth
—
No active session
Start a visit from the queue
DH
Blood Pressure
128/ 82 mmHg
▲ Slightly elevated
Heart Rate
74bpm
● Normal
SpO₂
98%
● Normal
Glucose
142mg/dL
▲ Above target
Live video via Jitsi (WebRTC). Public meet.jit.si is fine for testing but not HIPAA-compliant — set a self-hosted/BAA Jitsi domain for real PHI.
Visit Queue
5 waiting
JW
James Wilson
Primary Care · Follow-up
RK
Robert Kim
Orthopedics · New Patient
DT
David Torres
Primary Care · Check-in
AL
Angela Lee
Primary Care · Labs review
PS
Priya Sharma
Neurology · Urgent follow-up
Session Notes (AI Transcription)
Dr. Harper: How has your blood sugar been since we adjusted the metformin?
James Wilson: Better overall but still spiking after dinner. I've been checking twice a day.
Dr. Harper: Good discipline. Your glucose today is 142 which is above target. Let's review your evening meals...
AI transcribing… auto-generating SOAP note
James Wilson: Better overall but still spiking after dinner. I've been checking twice a day.
Dr. Harper: Good discipline. Your glucose today is 142 which is above target. Let's review your evening meals...
AI transcribing… auto-generating SOAP note
Recent Telehealth Sessions
| Patient | Provider | Date | Duration | Type | Recording | Status | Actions |
|---|
Referral Intake 6
Robert Kim
Orthopedics · Referred by Dr. Patel
Marcus Webb
Cardiology · ER transfer
Linda Chen
Neurology · Self-referred
Initial Assessment 8
Priya Sharma
Neurology · MRI ordered · PACS linked
Tom Nakamura
Primary Care · Blood work · HL7 pending
Active Treatment 14
Maria Gonzalez
Cardiology · Medication phase 2
James Wilson
Primary Care · Diabetes mgmt
Monitoring 11
David Torres
Primary Care · 3-month check-in
Susan Okafor
Cardiology · Reactivation due
Discharged 42
Kevin Shah
Orthopedics · Recovery complete
2 live agents · 6 in preview
Clinical Triage Agent
Monitors incoming patient data, flags at-risk patients, prioritizes cases by severity score, and routes urgent escalations to on-call providers.
Follow-up Coordinator
Automatically schedules post-visit follow-ups, sends reminders to patients with chronic conditions, and surfaces patients overdue for check-ins.
Prior Authorization Agent
Drafts and submits insurance prior authorization requests, tracks status, handles denials and appeals, and syncs results back to the patient record via FHIR.
Lab Results Interpreter
Ingests HL7 ORU messages and FHIR Observation resources, interprets abnormal results, generates plain-language summaries for providers, and updates patient timelines.
Billing & Coding Agent
Auto-generates ICD-10 and CPT codes from encounter notes, scrubs claims for errors, submits to payers via X12 EDI, and flags denials for review.
Smart Scheduler
Optimizes provider calendars using demand forecasting, suggests appointment slots to reduce no-shows, and balances telehealth versus in-person capacity.
Administrative Task Agent
Automates front-desk and back-office tasks: patient intake forms, insurance verification, referral routing, staff scheduling, compliance reminders, and document management.
Reporting Agent
Generates scheduled and on-demand clinical, operational, and financial reports. Surfaces AI-driven insights, anomaly detection, and trend narratives across all CRM modules.
Live Agent Activity Log
09:51:04TRIAGEFlagged Priya Sharma #PT-00502 — BP 158/96, headache + blurred vision → severity score 8.4/10 → escalated to Dr. Harper
09:50:38LABHL7 ORU^R01 received from Quest — 14 results parsed → 3 abnormal values flagged (HbA1c 7.8%, LDL 142, eGFR 61)
09:49:12PRIOR AUTHSubmitted PA request for Maria Gonzalez — Cardizem 240mg — Aetna ref #AET-20260408-9921
09:47:55BILLINGAuto-coded James Wilson encounter — ICD-10: E11.9, Z79.4 — CPT: 99213, 83036 — claim submitted $284
09:45:20FOLLOW-UPSent 6 appointment reminders via SMS — 3 confirmed, 2 pending, 1 failed
09:42:11FHIRFHIR R4 sync completed — Epic endpoint — 248 Patient, 1,340 Observation, 88 Condition resources updated
09:40:08TRIAGEReviewed 22 new vitals from IoT wearables — 1 alert generated for David Torres (resting HR 102 bpm)
09:38:44SCHEDULEPredictive model: 2 no-shows likely on Apr 10 (Thu) — suggested overbooking by 1 slot
09:35:02LABPACS DICOM SR received — Priya Sharma MRI Brain — study linked to FHIR DiagnosticReport #DR-20260408-0041
09:30:00SYSTEMAll 6 agents initialized — FHIR, HL7, PACS endpoints verified — system healthy
Agent Workflow — Patient Encounter Pipeline
Patient
Arrives
Arrives
→
Triage
Agent
Agent
→
Lab
Agent
Agent
→
Prior Auth
Agent
Agent
→
Billing
Agent
Agent
→
Follow-up
Agent
Agent
→
Encounter
Closed ✓
Closed ✓
Admin Task Agent
Runs in parallel — intake, insurance, scheduling, docs
Reporting Agent
Captures data at every stage — generates reports on demand
Tasks Automated Today
47
▲ 18% vs yesterday
Time Saved
6.2h
▲ Staff hours freed
Pending Verifications
9
▼ Insurance holds
Compliance Items
3
▼ Action required
Active Automations
Patient Intake
Run 112×
Auto-generates digital intake forms, pre-populates fields from FHIR Patient records, triggers e-signature via DocuSign, and archives to the EHR on submission.
Insurance Verification
Run 89×
Submits real-time eligibility checks (270/271 X12 EDI) to payers, validates coverage, deductibles, and copays, and flags patients with lapsed or insufficient insurance before their visit.
Referral Routing
Run 34×
Parses incoming referral faxes and HL7 REF messages, matches to best-fit specialist based on availability and specialty, and creates FHIR ServiceRequest resources automatically.
Staff Scheduling
Run 8×
Balances shift assignments using predicted patient volume, tracks PTO and on-call rotations, enforces nursing ratios, and publishes schedules to staff calendars via API.
Compliance Reminders
Run 21×
Tracks license renewals, mandatory training deadlines, HIPAA certification expirations, and Joint Commission audit dates. Sends escalating reminders 90, 30, and 7 days before deadlines.
Document Management
Run 58×
Classifies and routes incoming faxes, scanned documents, and uploaded files. Indexes content via OCR, links to patient records in the EHR via FHIR DocumentReference resources.
Active Task Queue47 today
Insurance verification — Robert Kim
Aetna PPO eligibility check · New patient pre-visit
Referral routing — Linda Chen
Incoming fax from Dr. Patel → Neurology
Intake forms — Marcus Webb
ER patient · Pre-populated from Epic FHIR record
HIPAA training — Amy Torres, LPN
Annual re-certification due in 7 days
Document OCR — Fax received 09:42
Lab report from Quest · Linked to PT-00502
Schedule optimization — Week of Apr 14
Balancing 5 providers · 3 PTO conflicts resolved
Prior auth status check — Maria Gonzalez
Aetna auth #AET-20260408-9921 · Pending 2hr
License renewal — Dr. James Park
Ohio medical license expires Jun 30, 2026
Compliance Dashboard
Joint Commission survey — overdue documentation
3 policies not updated since Jan 2026
HIPAA certification — 2 staff pending
Amy Torres, Nina Kim · Due Apr 15
DEA license — Dr. Arjun Patel
Expires May 31, 2026 · Renewal initiated
HIPAA Risk Assessment — completed
Annual assessment filed Apr 1, 2026
Agent Activity Log
09:51INTAKEMarcus Webb intake forms pre-filled from FHIR Patient/pat-00519
09:49INSRobert Kim — Aetna PPO eligibility confirmed · Deductible: $1,200 met
09:47DOCFax OCR complete — 2 pages → FHIR DocumentReference created #doc-00408
09:42REFReferral Linda Chen matched to Dr. Harper (Neurology) · ServiceRequest created
09:30COMPReminder sent — Amy Torres HIPAA cert due Apr 15 (7 days)
08:00SCHEDWeek of Apr 14 schedule published — 5 providers, 3 PTO conflicts auto-resolved
Reports Generated
12
▲ Today
Scheduled Reports
28
→ Next: 5:00 PM
AI Insights Found
7
▲ 3 new today
Data Sources
9
▲ All connected
AI-Generated Insights
Updated 09:51 AM · Next refresh in 9 min
No-show rate trending upward — April cohort +3.2%
No-show rate reached 11.4% this week, up from 8.2% last month. Analysis of appointment type and lead time shows cancellations cluster in afternoon slots (>3 days lead time) among primary care patients aged 25–40. Recommend activating 48h reminder automation for this segment.
View full analysis →
High impact
Telehealth adoption up 37% MoM — primary care leading
Telehealth accounted for 37% of all visits this month, up from 27% in March. Primary care visits drove 61% of the increase. Patient satisfaction scores for telehealth encounters (96%) now exceed in-person (92%). Revenue per telehealth visit averaged $148 vs $184 in-person — consider mixed-modality bundled care pricing.
View telehealth report →
Positive trend
Avg. discharge time 4.1hrs — 0.9hrs above benchmark
Discharge processing time has increased over the past two weeks, with bottlenecks identified at physician co-sign (avg 48 min delay) and pharmacy discharge medication reconciliation (avg 62 min delay). Automating co-sign reminders and pre-generating discharge prescriptions could reduce LOS by an estimated 55 minutes per patient.
View operational report →
Attention needed
Report Builder
Patient Volume — Apr 1–8, 2026
2,481
Total Patients
▲ 4.2%
187
This Week
▲ 8.1%
68
Telehealth
▲ 37%
8
No-shows
▲ 11.4%
Department Breakdown
Scheduled Reports
Daily Operations Summary
Active
Weekly Revenue & Billing Report
Active
Patient Satisfaction Monthly
Active
Provider Performance Quarterly
Active
FHIR Sync Health Report
Active
HIPAA Audit Log Report
Active
Admin Task Automation Summary
Active
FHIR R4 Endpoint
1,340
LiveLast sync: 2 min ago
HL7 v2 / v3 Messages
284
LiveADT, ORM, ORU active
PACS / DICOM Studies
47
LiveOrthanc PACS connected
FHIR R4
HL7 v2 / v3
PACS / DICOM
Base URL
https://fhir.citymedical.org/fhir/R4
Recent FHIR Resources
Patient
Priya Sharma — id: pat-00502
Synced
Observation
BP 158/96 — #obs-20260408-004
Flagged
DiagnosticReport
MRI Brain — #DR-20260408-0041
New
MedicationRequest
Metformin 1000mg — #mr-00398-07
Synced
Encounter
Telehealth visit #enc-20260408-JW
Active
Sync Activity
09:51PUTPatient/pat-00502 updated — vitals added
09:50POSTObservation/obs-20260408-004 created — BP flagged
09:49POSTDiagnosticReport/DR-0041 created — PACS linked
09:47GETCondition?patient=pat-00398 — 3 resources returned
09:42GETPatient?_count=100 — 248 resources fetched
09:38WARNMedicationRequest/mr-00289 — unknown code system
09:35PUTEncounter/enc-20260408-JW started — Telehealth
09:30GETCapabilityStatement fetched — Epic R4 endpoint verified
Supported Resources
Patient
Observation
Condition
MedicationRequest
Encounter
DiagnosticReport
Procedure
AllergyIntolerance
Immunization
CarePlan
Coverage
Appointment
Inbound Message Queue
ADT^A01 — Admit
Robert Kim admitted — Ward 3B
Processed
ORU^R01 — Lab Result
14 lab results — Quest Diagnostics
Processed
ORM^O01 — Order
MRI Brain ordered — Priya Sharma
Pending
MDM^T02 — Document
Discharge summary — Kevin Shah
Processed
Raw HL7 v2 Sample
Active HL7 Interfaces
Quest Diagnostics LIS
Cerner ADT Feed
Patient Portal HL7 Bridge
Recent Studies
MRI
Brain MRI w/ contrast
CT
Chest CT — PE protocol
XR
Right knee X-ray
ECH
Echocardiogram
PET
Whole-body PET scan
DICOM UID
1.2.840.10008.5.1
.4.1.1.4
.4.1.1.4
Storage Class
MR Image Storage
DICOM 3.0
DICOM 3.0
FHIR Link
DiagnosticReport/
DR-20260408-0041
DR-20260408-0041
Patient Volume — 12 Months
Provider Utilization
Visit Modality Split
In-person63%
Telehealth37%
Patient Satisfaction
94%
Based on 312 responses
Revenue Breakdown
Insurance57%
Self-pay28%
Medicare15%
MTD Revenue
$84,220
YTD Total
$318,440
Loading care models…
Organization
Team & Providers
Notifications
Care Models
Integrations
Compliance & HIPAA
Organization Settings
Manage your clinic or hospital's core information
Organization Name
NPI Number
Primary Contact
Phone
Address
Team & Providers
Manage staff access and provider profiles
| Name | Role | Department | Status |
|---|
Notification Settings
Configure alerts and automated communications
Appointment reminders (24h)
Auto-send SMS/email to patients
AI agent alerts
Notify providers of AI-flagged critical events
FHIR sync errors
Alert admin when FHIR sync fails or times out
HL7 message failures
Notify when inbound HL7 messages cannot be parsed
PACS new study alert
Notify radiologist and ordering provider on new study
Loading…
Integrations
EHR, interoperability, billing, and telehealth connections
Epic EHR · FHIR R4
Patient records, observations, encounters
ConnectedQuest Diagnostics · HL7
Lab results via ORU^R01 MLLP feed
ConnectedOrthanc PACS · DICOM
Imaging studies, DICOMweb WADO-RS
ConnectedCerner ADT · HL7 v2
Admission/discharge/transfer feed
ConnectedTwilio Video · Telehealth
WebRTC video sessions, recordings
ConnectedSubscription & Plans
View plans, upgrade, or manage billing
View plans →Compliance & HIPAA
Security and regulatory compliance settings
HIPAA Audit Logging
Log all access to protected health information
Two-factor authentication
Require 2FA for all staff logins
FHIR data encryption
TLS 1.3 for all FHIR API traffic, AES-256 at rest
Telehealth session encryption
End-to-end encryption for all video sessions
AI agent audit trail
Log all AI agent decisions for clinical review
✓ HIPAA Compliant · SOC 2 Type II · 21st Century Cures Act
Last audit: April 1, 2026 · Next scheduled: July 1, 2026
Total Encounters
47
▲ 9 today
Pending Orders
12
▼ 4 overdue
Avg. LOS (hrs)
3.2
▲ 0.4 vs target
Discharge Ready
6
→ Awaiting orders
Critical Alerts
3
▼ Needs review
ER
Emergency Dept.
Level I Trauma
18
Active cases
4
Critical
94 min
Avg wait
ICU
Intensive Care Unit
Ward 2A
9
Patients
2
Vented
12 beds
Capacity
OR
Operating Rooms
Surgical Suite
4
Active ORs
3
Scheduled
6 rooms
Total
MED
Med/Surg Ward
Wards 3A–3C
20
Patients
6
Discharge ready
25 beds
Capacity
Triage & Check-in5
Marcus Webb
Chest pain, SOB · Cardiac rule-out
Priya Sharma
Severe headache, blurred vision
Yuki Tanaka
Laceration, right hand · Work injury
Assessment7
Linda Chen
Altered mental status · Neuro eval
Tom Nakamura
Diabetic ketoacidosis · Endocrine
Rachel Evans
Palpitations · Echo + Holter
Diagnostics & Orders9
Maria Gonzalez
Troponin series · 3hr repeat
Marcus Webb
STAT ECG + Chest CT-PA
Angela Lee
CBC, CMP, lipid panel
Treatment & Procedures11
ICU Bed 4 — Anon.
Mechanical ventilation · Sedation protocol
James Wilson
IV insulin drip · BG monitoring q1h
OR 3 — Kevin Shah
Right knee arthroplasty · In progress
Observation & Monitoring8
David Torres
Post-procedure obs · HR monitoring
Robert Kim
Post-op knee · Pain protocol
Discharge Planning6
Susan Okafor
Cleared · Awaiting transport
Natalie Cross
Discharge orders signed · Rx sent
On-Shift Nurses
18
▲ Day shift full
Tasks Assigned
94
▲ 62 completed
Avg Patient Load
5.2
→ Recommended: 4
Overdue Tasks
8
▼ Escalation needed
Handoffs Today
14
▲ All documented
SR
Sarah Rodriguez, RN
Ward 3A · Charge Nurse
6
Patients
14
Tasks
2
Overdue
MP
Miguel Park, RN
ICU · Critical Care
3
Patients
22
Tasks
4
Overdue
AT
Amy Torres, LPN
Ward 3B · Med/Surg
4
Patients
11
Tasks
1
Overdue
NK
Nina Kim, RN
ER · Triage Nurse
5
Patients
18
Tasks
1
Overdue
Pending — Overdue8
ICU Bed 4 — Vent check
Ventilator settings review · q2h
Ward 3A Bed 7 — Pain reassess
Robert Kim · Post-op pain protocol
ER Bay 3 — IV access
Priya Sharma · 18G PIV right AC
Scheduled — Due Soon22
James Wilson — Insulin
Regular insulin 4 units IV · BG check first
Maria Gonzalez — Vitals
q4h BP, HR, SpO2, temp
ICU Bed 2 — Line care
Central line dressing change
In Progress14
Priya Sharma — Assessment
Neuro vitals, GCS, pupil check
Tom Nakamura — IV fluids
Normal saline 1L bolus · Rate 500 mL/hr
OR Recovery — Robert Kim
PACU monitoring, O2 sat, anesthesia wean
Completed62
Angela Lee — Morning meds
Metoprolol 25mg, Lisinopril 10mg given
David Torres — Wound care
Surgical site cleaned, sterile dressing applied
Maria Gonzalez — Blood draw
Troponin I, BNP sent to lab
Documentation11
Shift Handoff — 3A
Day to evening · SBAR report pending
ICU Flow Sheet Update
Hourly I&O, vent parameters
Fall Risk Assessment
Susan Okafor · Morse Fall Scale
Handoff / Escalation4
ICU Bed 4 — Rapid response
BP drop 88/54 · RRT called
Priya Sharma → Neurology
Transfer to neuro floor ordered
Active Physicians
8
▲ 6 on rounds
Pending Orders
16
▼ Signature needed
Consults Today
9
▲ 3 responded
Discharge Orders
6
→ Ready to sign
Critical Results
4
▼ Requires action
DH
Dr. Sarah Harper
Neurology · Attending
7
Patients
3
Consults
4
Orders
JP
Dr. James Park
Cardiology · Attending
5
Patients
2
Consults
6
Orders
LC
Dr. Linda Chen
Primary Care · Attending
8
Patients
1
Consults
5
Orders
AP
Dr. Arjun Patel
Orthopedics · Surgeon
4
Patients
3
Surgeries
1
Orders
Morning Rounds12
ICU Bed 4 — Critical review
Sepsis protocol · Vasopressors running
Marcus Webb — Chest pain eval
NSTEMI workup · Troponin trending up
Maria Gonzalez — Cardiology
EF review, medication adjustment
Pending Orders16
STAT — Norepinephrine drip
ICU Bed 4 · 0.1 mcg/kg/min IV
Heparin infusion — Marcus Webb
60 units/kg bolus then 12 units/kg/hr
MRI Brain w/ contrast
Priya Sharma · Headache + visual changes
Consults9
Neuro consult — Marcus Webb
Requested: stroke evaluation
Cardio consult — Priya Sharma
BP management, rule out hypertensive emergency
Endocrine consult — Tom Nakamura
DKA management, insulin titration
Procedures5
OR 3 — Knee arthroplasty
Kevin Shah · Dr. Patel · In progress
Bronchoscopy — ICU Bed 2
Diagnostic + BAL · Sedation required
Echocardiogram — Rachel Evans
Bedside TTE · Cardiology
Critical Results4
K⁺ 6.2 mEq/L — Tom Nakamura
Critical hyperkalemia · Immediate action
Troponin 0.8 ng/mL — Marcus Webb
Trending up · NSTEMI likely
MRI — New lesion · Priya Sharma
3mm right parietal signal change
Discharge Orders6
Susan Okafor — Ready
Orders signed · Rx sent to Walgreens
Natalie Cross — Ready
Neurology cleared · Follow-up Apr 22
David Torres — Pending co-sign
Orders drafted · Attending co-sign needed
Overall CSAT Score
4.7/5
★★★★★
▲ 0.2 vs last month
Net Promoter Score
+68
Promoters 78% · Detractors 10%
▲ +4 pts vs Q1
Responses This Month
312
Survey response rate
▲ 34% response rate
Open Complaints
7
3 escalated · 4 in review
▼ 2 new today
Sentiment OverviewFull report →
😊 Positive 68%
😐 Neutral 22%
😞 Negative 10%
Monthly Trend (CSAT)
Oct
Nov
Dec
Jan
Feb
Mar
Apr
By Department
Survey Question ScoresEdit survey →
How satisfied were you with your care today?4.7
Was your provider on time for your appointment?3.8
Did staff communicate clearly and respectfully?4.9
How easy was it to schedule your appointment?4.1
How would you rate the cleanliness of our facility?4.8
Did your provider explain your treatment plan clearly?4.6
Would you recommend us to a friend or family member?4.5
How satisfied were you with billing and checkout?3.6
Feedback Pipeline
New Responses 24
★★★★★
5.0"Dr. Park was incredibly attentive and explained everything about my heart condition so clearly."
★★★★☆
4.0"The telehealth visit was smooth. Wait time was a little long but the doctor was thorough."
★★☆☆☆
2.0"Waited over an hour past my scheduled time. No one explained the delay."
★★★★★
5.0"Front desk staff were welcoming and efficient. Best experience I have had here."
Under Review 7
★☆☆☆☆
1.0"The billing process was confusing and I was charged incorrectly. Still unresolved after 2 weeks."
★★★☆☆
3.0"The doctor was good but the discharge process took way too long. I was ready to go for 2 hours."
★★☆☆☆
2.0"Had to repeat my medical history 3 different times to 3 different staff members. Very disorganized."
Action Needed 7
★☆☆☆☆
1.0"I felt dismissed when I raised concerns about my medication side effects. Will be looking for a new provider."
★☆☆☆☆
1.0"My appointment was cancelled last minute with no explanation and no follow-up to reschedule. Unacceptable."
★★☆☆☆
2.0"Parking situation is terrible. Spent 25 minutes searching — was late to my appointment because of it."
Escalated 3
★☆☆☆☆
1.0"Potential medication error — received wrong dosage instructions at discharge. Filed formal complaint."
★☆☆☆☆
1.0"Privacy concern — another patient's records were visible on the computer screen at check-in."
Resolved 48
★★☆☆☆
2.0"Billing error resolved — refund issued. Staff followed up same day. Very grateful."
★★★★★
5.0"After my complaint about wait times they called to apologize and gave me priority scheduling. Impressed."
★★★★☆
4.0"Parking issue addressed — new signage installed. Follow-up call from admin appreciated."
Active Alerts & Follow-ups3 urgent
Medication error complaint — Patient #COMP-2026-0041
Quality dept notified · Risk management review pending · 7 days open
HIPAA privacy complaint — #COMP-2026-0038
Compliance officer review · IT audit requested · 9 days open
Billing dispute — Robert Kim · Incorrect charge
Finance team reviewing · 2 days open
Discharge wait time — 3 complaints this week
AI flagged pattern · Operations review recommended
1-star review — appointment cancellation · Neurology
Outreach call scheduled · Patient at risk of leaving
Provider Satisfaction ScoresCompare trends →
DH
Dr. Sarah Harper
4.7
★★★★★
JP
Dr. James Park
4.9
★★★★★
LC
Dr. Linda Chen
4.5
★★★★½
AP
Dr. Arjun Patel
4.3
★★★★☆
CMS Overall Star Rating
4
/5 stars
▲ +1 star from 2025
★★★★★
Medicare Patients
841
Medicaid Patients
312
VBC Revenue
$184k
Shared Savings
$22k
MIPS Score (2026)
87.4
Exceptional Performance
ACO Shared Savings
$22,400
Track 1 · Qualifying
Penalty Risk
Low
1 measure below threshold
Star Rating Breakdown
Process of Care
★★★★★
▲ 5 star
Outcome Measures
★★★★☆
▲ 4 star
Patient Experience
★★★★☆
▲ 4 star
Efficiency & Cost
★★★☆☆
→ 3 star
Preventive Care
★★★★★
▲ 5 star
Penalty & Bonus Flags
Readmission Rate — 30-day · HF patients
Current rate 18.2% exceeds 15% CMS benchmark. Risk of HRRP penalty up to 3% of Medicare DRG payments. Requires care coordination intervention.
MIPS — Promoting Interoperability below threshold
Current PI score 68/100 — threshold is 75. FHIR patient access API attestation incomplete. Risk of 4% Medicare payment adjustment.
MIPS Exceptional Performance Bonus — Qualifying
Overall MIPS score 87.4 exceeds 85-point exceptional threshold. Eligible for positive payment adjustment up to +1.88% of Medicare reimbursements.
ACO MSSP Track 1 — Shared Savings Qualifying
Achieved quality score ≥ 30th percentile. Benchmark expenditure savings of $22,400 for current performance year.
MIPS Quality Measures87.4 pts
Diabetes HbA1c Control
10/10
▲ Met
Hypertension Control
8/10
▲ Met
Breast Cancer Screening
10/10
▲ Met
Colorectal Cancer Screening
8/10
▲ Met
30-Day Readmissions (HF)
3/10
▼ Below
Depression Screening
10/10
▲ Met
Statin Therapy — CVD
10/10
▲ Met
Promoting Interoperability68 pts — Below threshold
e-Prescribing
10/10
▲ Met
Health Info Exchange
10/10
▲ Met
Patient Access API
5/10
▼ Incomplete
Provider to Provider
10/10
▲ Met
Public Health Reporting
7/10
→ Borderline
ACO Beneficiaries
1,153
MSSP Track 1 Active
Per-Beneficiary PBPM
$742
Below benchmark $814
Attributed Providers
12
All participating
VBC Program Performance
ACO MSSP (Medicare)$22.4k▲ On track
PCMH (Medicaid)Tier 3▲ Recognized
CPC+ Track 2$3.1k→ Partial
Merit-Based Incentive (MIPS)+1.88%▲ Exceptional
High-Risk Patient Management28 patients
5 CHF patients — readmission risk high
AI flagged · Care coordinator outreach due
11 diabetes patients — HbA1c > 9%
Endocrine consult recommended · HEDIS flag
8 hypertension patients — BP > 140/90
Medication adjustment flagged by AI agent
4 patients — overdue preventive screenings
Colorectal + breast cancer screening due
CMS Compliance Checklist2 items pending
HIPAA Privacy & Security — Compliant
Annual risk assessment completed Apr 1, 2026. All staff training current. BAAs in place with all covered entities.
CLIA Laboratory Standards — Certified
Certificate of Compliance issued Jan 2026. Proficiency testing participation 100%. Next inspection due Jan 2028.
21st Century Cures Act — Patient Access API
FHIR R4 Patient Access API partially implemented. SMART on FHIR launch context incomplete. Deadline: Jun 30, 2026. Risk of information blocking penalty.
OIG Exclusion Screening — Pending monthly run
Monthly exclusion list check due Apr 10, 2026. All staff and contractors must be verified against OIG, SAM.gov databases.
No Surprises Act — Billing Compliance
Good Faith Estimates provided for all self-pay patients. Advanced EOB process implemented. No open complaints.
Medicare & Medicaid Billing Compliance
Medicare Claim Accuracy98.2%▲ Excellent
Medicaid Denial Rate4.1%▲ Below 5% target
RAC Audit ExposureLow→ Monitor
Timely Filing Rate99.1%▲ Excellent
Upcoding Flags (AI)2 flags▲ Under review
All CMS submission deadlines, reporting windows, and attestation due dates for City Medical Center — 2026
MIPS 2025 Data Submission — Final deadline
Due: May 31, 2026 · Quality + PI + IA + Cost · CMS IPPS portal
21st Century Cures — Patient Access API Attestation
Due: Jun 30, 2026 · FHIR R4 SMART on FHIR · CMS Blue Button 2.0
OIG Exclusion Screening — Monthly run
Due: Apr 10, 2026 · All staff + vendors · SAM.gov + OIG LEIE
MSSP ACO Annual Quality Report
Due: Aug 1, 2026 · Performance Year 2025 · ACO REACH portal
HEDIS Measure Reporting — Medicaid
Due: Jul 15, 2026 · NCQA HEDIS 2026 · Managed care plans
CPC+ Track 2 — Performance Year Report
Due: Sep 30, 2026 · Comprehensive Primary Care Plus
HCAHPS Survey — Q1 2026 Submission
Submitted: Apr 1, 2026 · 312 responses · 4.7/5 overall · ✓ Complete
Inpatient Quality Reporting (IQR) — Q4 2025
Submitted: Feb 1, 2026 · QualityNet portal · ✓ Accepted