DeskGate BAA active · Vertex AI · 28 Sep 2026

Payer appeals · Offshore delivery pods · US payer work

We draft the appeal your floor has no time to write. Quoted chart facts. [MISS] where the chart is silent. Human Submit.

Work the denials and non-API prior authorizations your floor has been writing off, on the payer portal family it already works, without inventing clinical necessity. Your agency keeps the client relationship and every dollar it recovers. The coordinator still clicks Submit.

Claim a free 30-day pod test Master terms: Schedules S, I and M

Section 0 · The RCM agency covenant

Internal workstation vendor. Not a competing RCM shop.

DeskGate does not bill professional services. It does not take the clinic contract. Under the Master Terms and Order Form, DeskGate covenants that it will not contact, solicit, market to or contract with the underlying healthcare providers or physician clients of a licensed agency partner for competing billing or prior-authorization labor.

You keep the relationship. We license the desk.

What is on the floor today

Two monitors. The minutes die in the swivel between them.

Pune, Chennai, Hyderabad, Manila, Cebu, Lahore, Florida, Texas, California: the desk is almost always two monitors. Monitor 1 is the clinic record. Monitor 2 is the payer portal.

Monitor 1 · Left

Clinic records

  • Tab 1 · EHR or PM system

    athenahealth, eClinicalWorks, Kareo/Tebra, Dentrix/Open Dental, or Citrix into Epic or NextGen. Demographics, pending order, schedule.

  • Tab 2 · Chart PDF

    Encounter notes, labs, step-therapy failures, periodontal charts. READ CHART reads what is on screen (a tab, a PDF or a shared Citrix window) into the side panel's memory. DeskGate never logs into the EHR.

  • Tab 4 · Agency tracker

    Sheet or ticketing: case, payer, CPT/CDT, start, finish, reference, status. Your SLA math stays on your sheet.

Monitor 2 · Right

Payer portal and DeskGate

  • Tab 3 · Authenticated payer portal

    The payer portal the desk already works: Availity, CoverMyMeds, UHC Provider Center, a state Medicaid or dental portal. Already logged in with that coordinator's Okta or Duo. No remote headless browser.

  • DeskGate Chrome side panel

    Docks on this window. STAGE APPEAL and STAGE PORTAL fill the open payer form. Submit stays with the human, on the portal. GATE sends a hash only. Chart facts are held in the side panel, not written to DeskGate databases; screen reads go to Gemini on Vertex AI under DeskGate's Google Cloud BAA. NEW CASE clears the panel.

Swivel chair vs DeskGate

Same desk, same portal. The draft is already written.

The coordinator does the same job on the same two monitors. What changes is who writes the draft and retypes the boxes—whether it is a denial reconsideration, a step-therapy appeal, or a non-API prior authorization.

Today

Most denials never get an appeal.

  1. Open the denial letter on Monitor 1. Find the reason and the payer reference.
  2. Search the chart for the evidence the payer says is missing.
  3. Write the rebuttal in Word. Paste it into the appeal form on Monitor 2.
  4. Retype name, DOB, member ID, NPI and codes. Portal timeout. Start again.
  5. No time left for the next denial, so it gets written off.

With DeskGate

The appeal is drafted for you.

  1. READ CHART on the denial letter, then on the chart. The facts go into the side panel.
  2. Focus the appeal or PA form on Monitor 2. Click STAGE APPEAL or STAGE PORTAL.
  3. Gemini on Vertex AI matches each box on the form. DeskGate types the letter built from quoted chart facts, marks [MISS] where the chart is silent, and reads every box back.
  4. The coordinator checks the draft against Monitor 1, edits anything wrong and attaches the files the portal asks for.
  5. The coordinator clicks Submit on the portal. Then GATE: the payer reference is hashed in the browser. The raw reference is not sent.
Honest limits, said before day 1. DeskGate reads only what is on screen when the coordinator presses READ CHART; it never logs into the EHR or the payer. Where the chart says nothing, the draft says [MISS] instead of inventing it. DeskGate never attaches a file and never presses Submit. Unattended Submit is refused. A coordinator edit after STAGE counts as a Schedule M material edit, not a product failure.

What we license (Schedule S)

In profit from the 1st to 3rd overturned claim per month.

Start with the 30-day free measurement on one named portal family. After day 30, pick the tier that matches your pod or floor size—with zero per-case fees and zero share of your recovered collections.

Starter Pod / Single Clinic (1–3 seats)

S-Practice

$490/month

or $5,400/yr prepaid · first 30 days $0

  • One named portal family (e.g. Availity, CoverMyMeds, Dental)
  • 1 to 3 coordinator seats or providers
  • Zero case metering or collection share
  • Breaks even on 1 collected $800 claim/month

Delivery Pod / Surgery Center

S-Desk

$1,950/month

or $21,000/yr prepaid · first 30 days $0

  • One named portal family
  • Unlimited coordinators on that desk
  • Zero case metering or collection share
  • Breaks even on 3 collected $800 claims/month

Multi-Lane Agency Floor

S-Agency

$4,900/month

or $54,000/yr prepaid · first 30 days $0

  • Up to three named portal families
  • Unlimited coordinators across the agency floor
  • Section 0 provider non-solicit covenant
  • Breaks even on 6 collected $800 claims/month

First 10 desks get 30 days free on one named portal family in exchange for a pre-period baseline count and a blinded Schedule M ledger at day 30. Larger multi-site MSO networks: talk to us.

What a delivery head asks

Five questions before day 1.

Does this replace my coordinators?

No. It drafts the appeal and stages the fields on the portals they already use. Whether the same pod then clears more completed units per coordinator-day is what day 30 measures. The filing actor stays the coordinator. Throughput is measured against your own before-count. We do not underwrite a headcount cut or an EBITDA percentage.

Do you log into our client EHRs?

No. Coordinators keep their own EHR, Citrix and payer logins. DeskGate runs in Chrome on the payer tab after they have already passed Duo or Okta. We do not put a headless browser in your VPC.

Will you take our doctor clients?

No. That is the Section 0 covenant. We sell the workstation license to the agency. The clinic relationship stays yours.

Which contracts benefit most?

Percentage-of-collections and fixed-fee contracts: every extra appeal your pod files is revenue you keep. If you bill clients by the staff hour and coordinators do get faster, that means fewer billable hours, so price that in before you start.

What does day 30 show you?

Completed units (human Submit plus hashed payer reference) per coordinator-day against your before-count. Gate-accept rate. Material-edit rate. Autonomous Submit: zero. Member ID, name, DOB, notes, screenshots and raw references never go into the ledger.

Next step

Put one pod on one portal family for 30 days.

Tell us which portal family costs your floor the most coordinator time. We stage that lane, and both sides read the same ledger on day 30.

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