AI-Powered Chronic Care Management
Carenox recovers 30–40% of lost billable patient-months, optimizes CPT codes for 45–76% higher revenue per patient, and scales coordinators 3–5x with AI voice agents.
The Problem
Most practices lose 30–50% of enrolled patients each month to silent compliance failures. Nobody notices until the claim is denied or the month is over.
Expired consents, stale visits, 18 minutes logged instead of 20 — patients slip through compliance cracks silently.
All 5 CMS compliance gates run continuously. Consent, visit, time, documentation, billing conflicts — checked in real-time.
5–10 minutes per patient on chart review and time tracking. Coordinators spend more time on admin than actual care.
Pre-call prep drops to zero. AI handles routine wellness checks. Auto time capture eliminates manual tracking.
Most practices bill only 99490 ($62) and stop — missing higher-value CPT codes worth $90+ per patient.
Tracks all four CPT thresholds. Nudges coordinators toward higher-value codes with exact dollar impact.
Core Features
AI voice agent "Sam" conducts structured wellness checks in English, Hindi, Russian, and French. Live transcript streaming with coordinator monitoring and instant takeover.
Prioritized patient queue with time progress bars. Auto-drafted summaries before check-ins. Smart outreach with rule-based and AI-powered optimization.
Narrative patient timeline showing every interaction. Real-time care plan updates with immutable history. Clinical note export for EHR integration.
Immutable audit trail on 16 PHI tables. Automated compliance reporting with CSV export. Role-based access with MFA enforcement and 15-min auto-logoff.
Real-time billing gate evaluation across your entire panel. CPT pathway comparison with revenue estimates. Month-end rescue queue sorted by dollar impact.
Multi-tenant design with row-level security. HIPAA-ready infrastructure with BAA compatibility. FHIR-ready APIs for Epic, Cerner, and Athenahealth.
How It Works
AI identifies patients needing contact based on rules and patterns. Coordinators see a daily worklist ordered by priority score with one-click calling and pre-loaded patient context.
AI agent handles routine wellness questionnaires while the coordinator monitors the live transcript. Take over anytime clinical judgment is needed. Call duration is automatically captured.
AI generates clinical notes from the conversation. Time entries are logged against correct CPT thresholds. Follow-ups are scheduled based on call outcomes.
System checks all 5 CMS gates in real-time. Blockers are highlighted with specific resolution steps. Rescue queue surfaces last-minute revenue opportunities.
Admin review and sign-off workflow. CPT code optimization suggestions with side-by-side revenue comparison. Clean claim generation for billing teams.
Compliance & Trust
Built for healthcare's strictest standards. No AI in the billing path — all compliance decisions are deterministic rules, fully auditable, no black-box decisions.
AES-256 at rest via Supabase. TLS in transit for all API calls. HSTS headers with preload. Content Security Policy enforced.
TOTP-based MFA enforcement. 15-minute auto-logoff. Three-tier RBAC: coordinator, admin, super-admin. Break-glass emergency access with full audit trail.
Immutable logs on all 16 PHI tables. 6-year archival with 7-year destruction threshold. Automated compliance CSV exports for BAA auditors.
Append-only history for time entries and care plan changes. Row-level security for multi-tenant isolation. Failed audit writes roll back the entire transaction.
Outcomes
Practices recover 30–40% of previously lost revenue through real-time compliance checking and rescue queues.
CPT code optimization moves patients from $62 (99490 only) to $90+ through threshold nudging — same patients, same enrollment.
AI handles routine calls and eliminates 5–10 minutes of chart prep per patient. One coordinator manages 250–400 patients.
Immutable logs, automated compliance reports, and structured CSV exports satisfy BAA auditor requirements out of the box.
Who It's For
Manages 80–120 chronic care patients
Spends too much time on chart review, manual time tracking, and figuring out who to call next.
"Prioritized queue tells me exactly who to call next, AI handles the routine work, and I never miss a billable minute."
Responsible for 200+ patient-month billing
Discovers compliance gaps after the month closes. No visibility into which patients are close but blocked.
"Real-time gate evaluation and rescue queue let me fix issues before they become lost revenue."
Runs multi-provider CCM program
Can't quantify program efficiency or revenue leakage. Growth means more hires.
"Revenue dashboards show exactly where we're leaving money on the table, and AI scaling means growth without new hires."
Social Proof
"Carenox recovered $42,000 in lost billable months in our first quarter. The rescue queue alone paid for the platform. Our coordinators now manage 3x more patients without burnout."
"The compliance reporting saved us 40 hours of manual audit prep last quarter. Having immutable logs and automated CSV exports gave our BAA auditor exactly what they needed."
Trusted by healthcare organizations nationwide
FAQs
Most practices are live in 2–4 weeks. We handle EHR integration, staff training, and data migration. No disruption to current workflows — Carenox runs alongside your existing systems during onboarding.
Yes. We implement 85% of HIPAA technical safeguards including MFA, encryption, immutable audit logs, and role-based access. Infrastructure runs on BAA-covered providers. No AI in billing decisions — all compliance logic is deterministic and fully auditable.
We integrate via FHIR APIs and clinical note export. Current partners include Epic, Cerner, and Athenahealth. Custom integrations are available for other systems. Our architecture is designed to be integration-friendly from day one.
"Sam" uses condition-specific questionnaires — not trained on patient data. Speaks English, Hindi, Russian, and French. All calls are monitored by coordinators via live transcript who can take over anytime clinical judgment is needed.
Per-patient per-month with volume discounts. Carenox typically pays for itself within 90 days through recovered revenue and efficiency gains. Contact us for a personalized ROI analysis based on your panel size.
Dedicated implementation manager, 24/7 technical support, quarterly business reviews, and ongoing staff training. We're a partner, not just a vendor — your success is how we measure ours.
See exactly how much revenue you're leaving on the table with a personalized ROI analysis.
Demo includes: Custom revenue recovery estimate · Platform walkthrough · Implementation timeline