MedScribe AI makes sure it passes all three — and captures the APR-DRG severity your coders need, in both English and Spanish, exported MEDITECH-clean.
Designed and built by a practicing hospitalist inside Puerto Rico's hospital system — not an outside tech company retrofitting generic AI.
The Three-Test Framework
Does the documentation actually support the CPT level and APR-DRG severity captured? We run every note through 46+ clinical safety rules, an evidence-anchored ICD-10 / CPT coding engine, and a deterministic MDM matrix based on AMA 2021 E/M and CMS MPFS 2023 time thresholds. No hallucinated diagnoses, no unsupported procedures, no tense errors.
Does it withstand a CMS, ASES, or internal audit? The validator blocks on missed NSAID-in-CKD cross-checks, AKI-vs-ESRD coding conflicts, unsupported sepsis claims, and 12 more hard-safety rules. Advisory-only rules surface documentation specificity gaps (CKD stage, CHF LVEF, pneumonia setting) that drive APR-DRG tier capture — the single biggest reimbursement lever no other scribe addresses.
Does it hold up in a malpractice review? Every draft is explicitly a draft until the physician signs. Every AI suggestion has an accept / edit / reject audit trail in the database. PHI is redacted before any egress to OpenAI. Every PHI-touching action is logged. HIPAA-conscious architecture with staged BAA execution — we do not make compliance claims we can't back up.
The Math
| Lever | Per physician / year | 10 physicians / year |
|---|---|---|
| Time savings — 40% reduction × 2 hr/day documentation × 240 shifts × $180/hr opportunity cost | $34,560 | $345,600 |
| Billing-score lift — MDM capture from 99232 → 99233 on ~15% of encounters × 2,000 encounters × $36 delta | $10,800 | $108,000 |
| APR-DRG severity tier capture — SOI tier shift on ~8% of admissions (PR-specific moat) | TBD per hospital | Measured in pilot |
| Reduced CDI query-back rate — ~30% fewer downstream queries, ~2 hr/wk reclaimed per coder | — | ~$20,000 |
| Floor estimate (time + billing-score only) | $453,600 / year | |
| SHM-benchmarked median billing-score lift per hospitalist: | $14,000 / year | |
APR-DRG lift is the largest unmeasured upside and is specific to the Puerto Rico Medicaid payment formula. We cannot quote it precisely until Phase 2 of the pilot runs on your actual case mix.
What Hospital Leadership Gets
Documentation prompts for severity specificity (acute vs chronic, stage, etiology) that drive SOI/ROM tier capture under Puerto Rico's payment formula. No other scribe has this.
Evidence-anchored ICD-10 / CPT suggestions, cited from the physician's own note text — not inferred, not hallucinated. 43+ validated rules today, growing.
Dictate in Spanish, English, or mixed. Output reads as if written by a native clinician in either language. Section labels, MEDITECH exports, and CDI prompts all bilingual.
ASCII-safe, properly sectioned, copy-paste clean. No reformatting inside your EHR. Future SMART-on-FHIR integration roadmap.
Every note gets permanent copilot-mode validator review before sign. NSAID in CKD, beta-blocker in decompensated CHF, AKI vs ESRD coding integrity, sepsis criteria cross-check, and growing.
Dark mode, 2-click Quick Record, auto-save, session-expiry warnings. Works on iPhone at the bedside. Built by a nocturnist for night-shift realities.
The Pilot
Compliance Posture
We claim 'HIPAA-conscious architecture with staged BAA execution.' That is the honest posture.
Why MedScribe — Not the U.S. Incumbents
The Puerto Rico Medicare Advantage market is roughly $10 billion and structurally under-served by every U.S. scribe vendor. The first hospital system to deploy a bilingual, ASES-aware AI scribe gets the narrative, the case studies, and the operational head start.
Next Step
Request a 30-minute call with your CMO, CFO, and CMIO. We will walk through the product, the staged-BAA pilot structure, and the specific documentation gaps in your case mix that drive APR-DRG reimbursement today.
Dr. Hiram Rodriguez, MD
Founder & Lead Clinician · Board-certified Internal Medicine / Hospitalist / Nocturnist