For Medicare-enrolled clinics and providers
Launch technology-supported chronic care
for your Medicare patients.
Carenox handles patient engagement, outcome measurement, care coordination updates, and ACCESS reporting — working alongside your clinical team. From consent-first AI outreach to audit-ready documentation, we automate the operational layer so clinicians focus on clinical decisions.
How It Works
From patient outreach to clean billing.
Risk Stratification
Explainable, points-based scoring across 12 clinical features: chronic conditions, utilization history, polypharmacy, frailty markers, and social determinants. Patients who need more care surface first.
Rule-Based Care Gap Detection
Continuous monitoring against clinical guidelines, HEDIS measures, and CMS quality measures. Overdue labs, missed follow-ups, medication adherence gaps — flagged automatically.
Consent-First AI Outreach
Voice agent handles structured wellness questionnaires in English, Hindi, Russian, and French. Patients opt in; they can opt out anytime. Built on BAA-eligible conversational AI and telephony infrastructure.
Live Transcript & Takeover
Coordinators monitor every AI call in real-time via streaming transcript. One-click takeover when clinical judgment is needed. Call audio processed in transit, not retained beyond session transcript.
Patient Timeline & Notes
Unified narrative timeline of all interactions. Auto-generated structured notes from call transcripts with inline editing. Clinical note export compatible with Epic, Cerner, and Athenahealth via FHIR R4.
CPT Optimization & Rescue Queue
Identifies patients qualifying for higher-value CPT codes beyond 99490. Month-end rescue queue surfaces patients close to billing thresholds, sorted by revenue impact. Side-by-side CPT pathway comparison.
ACCESS Model Readiness
Designed for CMS outcome-aligned payments.
ACCESS begins July 5, 2026 — a 10-year model paying for measurable clinical improvement. Carenox supports the operational and technical requirements across all four tracks.
PHQ-9 and GAD-7 administered conversationally. WHODAS 2.0 collection. Longitudinal score tracking against baseline.
Validated PROM administration. Pain intensity, interference, and function tracked over time.
RPM device integration (BP, weight). Patient engagement for adherence. Care gap alerts for missed readings.
Lab reminders. Medication adherence. eGFR/UACR data handling. PCP care coordination updates.
Outcome Attainment Threshold: ACCESS pays 100% when at least 50% of patients meet clinical targets. Carenox's continuous engagement and longitudinal measurement supports organizations working toward this bar.
Broader eligibility: Unlike traditional CCM (2+ chronic conditions), ACCESS accepts patients with a single qualifying condition — expanding the eligible population from the same clinic panel.
Compliance & Security
Architected to HIPAA technical safeguard standards.
BAA available for all covered entities. No AI in the billing path — all compliance logic is deterministic and fully auditable.
Encryption
AES-256 at rest. TLS 1.3 in transit. HSTS with preload. Content Security Policy enforced. All infrastructure on BAA-covered providers.
Access Control
TOTP-based MFA enforcement. 15-minute auto-logoff. Three-tier RBAC: coordinator, admin, super-admin. Break-glass emergency access with full audit trail.
Audit Trail
Immutable, append-only logs on all PHI tables. 6-year archival with 7-year destruction threshold. Automated compliance CSV exports for BAA auditors.
Clinical Oversight
Designed for physician Clinical Director oversight per ACCESS requirements. Escalation pathways for clinical decisions. Coordinator takeover at any point during AI calls.
Pilot Program
Start with 100 patients. See results in 90 days.
Up to 100 patients · 3-month pilot
- Full platform access — all features
- AI Care Companion (4 languages)
- Real-time compliance gating
- CPT code optimization
- Outcome measurement & tracking
- Dedicated implementation manager
- 2–4 week implementation
No setup fees. No long-term contract. Cancel anytime.
Start PilotFAQs
Common questions.
2–4 weeks from signed agreement to go-live. We handle EHR integration, staff training, and patient roster onboarding with no disruption to current workflows.
Built on FHIR R4 standards with clinical note export. Designed for compatibility with Epic, Cerner, and Athenahealth. Custom integrations available for other systems.
Built on BAA-eligible conversational AI and telephony infrastructure. Uses condition-specific questionnaires, not trained on patient data. Call audio processed in transit and not retained beyond the session transcript. Speaks English, Hindi, Russian, and French. Coordinators monitor via live transcript and can take over anytime.
We are building toward ACCESS participation (targeting the April 2027 cohort). The platform is designed to meet ACCESS operational and technical requirements from day one, including outcome measurement, care coordination, and CMS API reporting readiness. Today, we serve traditional CCM programs with the same infrastructure.
Architected to HIPAA technical safeguard standards. AES-256 encryption at rest, TLS in transit, MFA enforcement, immutable audit logs, RBAC, and 6-year archival. BAA available for all covered entities. All billing logic is deterministic — no AI in the claim path.
Dedicated implementation manager, shared Slack channel with next-business-day response, ongoing staff training, and quarterly reviews. We're a partner in your program's success.
Team
Infrastructure engineering meets healthcare operations.
Evaluate your ACCESS readiness.
20-minute call to review your patient panel, discuss eligibility, and see the platform live. No commitment.
We respond within 1 business day.