SHOWROOM · SYNTHETIC PATIENT JANE RIVERA. This page is not the install. The desk product is the DeskGate Operator Extension (v2.6.8): side panel, chart facts in RAM, human Submit, a ledger with a SHA-256 of the payer reference. The PDF on this page is a showroom export only. The extension does not write a dossier. See the extension at work on the walkthrough.
DeskGate Synthetic showroom
Delaware C-Corp 🏥 Healthcare Desk ⚙ How We Execute 🛡 Position 💼 Access & Pilot ✉ Contact
EXECUTION AFTER DECISION · HUMAN APPROVAL GATE · SYNTHETIC DEMO

After the platform decides,
DeskGate executes the residual

The intelligence layer already knows what should happen. Coordinators still spend residual minutes on authenticated screens, portal forms, verification calls, attachments and appeal drafts. DeskGate stages that work inside the coordinator's own browser session: it quotes facts already on the chart into the payer form, marks anything the chart does not say as [MISS], and stops. The coordinator reviews, attaches files and clicks Submit. Each case leaves a ledger row with a SHA-256 of the payer reference, not a dossier.

Name the lane. Measure one workflow. Operator stays the decision-maker.

Built for one buyer, the desk that files:
Independent clinics Specialty PA desks RCM & billing firms MSO / IPA operations Home health agencies
Clinical Assistant
The coordinator stays at the gate
ARCHITECTURE ANCHORS · HOW WE OPERATE ACROSS PAYER PORTALS FIRST 10 DESKS · 30 DAYS FREE

1. Cross-Tab Session Bridge

Operates inside the coordinator's authenticated browser session across tabs, using the 2FA, SSO and VPN logins already active there, so there is no outside login for bot checks to block.

2. Screen Grounding

Reads the rendered screen with Gemini on Vertex AI and finds fields by what they show and say, not by page code. That makes it resilient to most layout changes on payer sites. It is not immune: a redesigned form can still need a fresh mapping.

3. The Coordinator Remains the Filing Actor

DeskGate stops before Submit. Your licensed coordinator reviews, attaches files and clicks Submit, and remains the filing entity of record. Autonomous submissions: zero.

4. First 10 Desks · 30 Days Free

30 days free on one named portal family, with portal mapping and the 30-day Schedule M measurement at our cost. In exchange: one coordinator, a pre-period baseline and a blinded ledger DeskGate may publish. Practice-manager or billing-director sign-off. After day 30, stop or subscribe.

Reference Workstation · Synthetic Prior-Auth Path OPERATOR GATE · NO LIVE SUBMISSION
Synthetic Wegovy 0.25 mg · BCBS commercial PPO · intake → policy → necessity → telephony notes → appeal → summary
Synthetic data only. No clinical decision is made. Paths are labeled [LIVE] or [SIM]. The operator remains the approval gate before any irreversible action.
Status: Workstation Ready
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Benefit Verification & Patient Intake (Optic Stream)
Active
OPTIC FEED STANDBY
📷 Patient & Document Optic Camera Feed
Enable camera to see patient or hold up physical insurance card / medical documents for real-time OCR extraction
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Prior Authorization & Medical Necessity
Waiting
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Submission, Telephony Verifications & Live Tracking
Waiting
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Denial Risk & Appeal Staging
Waiting
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Final Case Summary & Handoff
Waiting
Built to sit under healthcare automation platforms

These are categories of teams whose work leaves a portal step behind. They are not partners, customers or integrations.

Specialty prior-auth platforms

The decision is made upstream. DeskGate handles the last step on portals with no API: it quotes chart facts into specialty prior-auth forms and step-therapy fields, marks gaps as [MISS] and stops for the coordinator.

RCM and billing platforms

Exception work the claims pipeline cannot reach: portal claim follow-up, eligibility disputes and payer web forms with no API. Staged in the coordinator's session; the coordinator submits.

Payer phone follow-up

Outbound and inbound verification calls for eligibility, PA status and benefits, with the case context carried along. Shown on this page as a showroom demo (Step 3); the desk install today is the browser extension.

Voice-AI teams

Voice agents that handle payer phone follow-up still leave a portal form behind. That form is where DeskGate works: in the coordinator's session, stopping before Submit.

DeskGate's key · desks bring no model keys

Screen reads run on DeskGate's account: Gemini on Vertex AI in project deskgate-production, under the Google Cloud BAA executed 28 September 2026, whose terms govern Google's side. Each desk signs its own BAA with DeskGate before a live chart is read. Chart notes and member IDs are not written to DeskGate databases; portal credentials stay in the coordinator's browser. The PDF on this page is a showroom export only.

OPERATOR ARCHITECTURE & SAFE DILIGENCE FAQ

Practical Diligence Notes for Operators & Investors

Key questions answered on first sight before connecting DeskGate under an existing PA or RCM stack.

✦ How do we reach external payer portals if mounted in an EHR?
DeskGate runs as a browser extension, the DeskGate Operator Extension, inside the coordinator's own Chrome or Edge session. It uses the SSO, Duo 2FA and hospital VPN connections already active there, across tabs, so it never logs in from outside the way a remote cloud bot does, and the Cloudflare/Akamai bot checks that stop cloud scrapers do not come into play.
✦ What happens as foundation-model browser control improves?
It helps us. We are a consumer of those models, not a competitor to them. DeskGate sends its screen reads to Gemini on Vertex AI in project deskgate-production, under the Google Cloud BAA executed 28 September 2026, and better grounding makes our staging cheaper and more reliable. What we add on top is the healthcare-specific part: payer SOP mapping, exception routing per portal family, the human gate, and the case ledger. We do not claim a foundation-model lab could not build this. We claim the accumulated portal behavior from live desks is what is hard to copy, and that is earned rather than architected.
✦ What exactly do the first 10 desks get?
30 days free on one named portal family, in exchange for one coordinator, a pre-period baseline and a blinded ledger DeskGate may publish. Practice-manager or billing-director sign-off is enough. They pick their worst payer portal and receive a 30-day ledger on it: completed cases per coordinator-day against their own written baseline, and — the part no portal report can give them — the share of packets accepted at the gate with no material edit. That second number is what says the software did the work rather than the coordinator retyping it faster.

After day 30, the desk stops or subscribes. S-Practice is $490/month or $5,400 prepaid for the year (1–3 seats, one named portal family, breaks even on 1 claim/mo). S-Desk is $1,950/month or $21,000 prepaid for the year (unlimited coordinators on that desk, one named portal family, breaks even on 3 claims/mo). S-Agency is $4,900/month or $54,000 prepaid for the year (up to three named portal families, zero case metering). There is no required 12-month commitment. Larger networks: talk to us.
✦ Where does clinical and legal accountability sit?
With your licensed coordinator, and it does not move. We do not sell unattended autonomous filing. The extension stages repetitive data entry, quoting facts already on the chart and marking anything the chart does not say as [MISS], then stops before Submit. The named coordinator reviews every [MISS], attaches files and clicks Submit; they remain the filing entity of record and can refuse. Autonomous submissions: zero. We make no clinical or medical-necessity determination. This reduces a specific class of risk — it does not eliminate liability, and no software can.
✦ Where does ePHI live? (HIPAA & what is retained)
Chart facts are held in the side panel's memory for the active case. Chart notes and member IDs are not written to DeskGate databases. Each completed case can post a ledger row with a SHA-256 of the payer reference, hashed in the browser; the pilot ledger stores the hash, not the reference. There is no dossier file.

One path does leave the browser and you should know about it: reading the payer screen sends a frame to a model provider, and that frame can contain PHI. On a licensed desk those frames go only to Gemini on Vertex AI in project deskgate-production, under the Google Cloud BAA DeskGate executed on 28 September 2026, whose terms govern Google's side (Master Terms §4). Anthropic is not used on desk lanes. A developer-tier Gemini key from AI Studio is not BAA-eligible and is for synthetic demos only.

To be plain: this is a data-minimizing design, not a compliance certification. Whenever DeskGate touches PHI for a covered entity it is itself a business associate, which requires our own BAA with the practice, signed before a live chart is read, plus a risk analysis and documented policies. Vendor agreements cover vendors; they are a prerequisite, not a substitute.
✦ What is live versus simulated in this demonstration?
Everything on this page is synthetic. Bright Data, Twilio, and the PDF export are website-demo tools. They are not what a desk installs. Live charts run only in the extension, after the desk's BAA and a desk key.

DeskGate, Inc. · Delaware C-Corporation · Last-mile execution for healthcare desks · Extension walkthrough · Healthcare Desk · How We Execute · Position & defensibility · Master Terms