A contractual advisory offering for providers and payers navigating the AI journey — an honest readiness picture across clinical and administrative operations, an executable roadmap, and AI that is responsible, auditable, explainable, and secure at the forefront.
Four patterns we see across health systems and health plans under pressure to "do AI" — each an argument for starting with advisory rather than procurement.
The ambient-scribe demo wowed the medical staff. Two years on it lives in one clinic — EHR integration, clinical governance, and unit economics were never scoped.
Clinicians paste notes into public chatbots; staff draft appeals with them. PHI is leaving the building ungoverned — and every paste is a reportable question.
Boards, compliance officers, and regulators are asking where AI touches clinical and coverage decisions — questions with no owner and no evidence trail.
Decades of systems grew apart: EHR here, claims platform there, faxes in between. Use cases get funded before anyone checks the data can carry them.
Four domains where AI moves real healthcare numbers — clinician time, cycle time, cost of compliance, and patient experience.
Ambient documentation, AI triage and guided intake, evidence-cited decision support, and care-team copilots grounded in the chart.
Straight-through adjudication, prior-auth automation, coding and billing support, and denial and appeals intelligence.
Deviation and complaint categorization, audit-ready document retrieval, policy lookup with citations, and quality-measure reporting.
Navigation and benefits assistants, correspondence drafting, post-discharge follow-up, and call-center copilots.
A two-to-three-week, fixed-fee diagnostic that replaces optimism with evidence — and gives the board a defensible starting point. Structured interviews with clinical, compliance, revenue-cycle, and IT leadership; technical deep-dives into the EHR and claims estate; scoring against our healthcare benchmark.
Interviews with clinical, compliance, rev-cycle & IT leadership
Deep-dives: data estate, EHR/claims landscape, privacy posture
Scoring, gap analysis, board-ready readout
Five phases, four executive gates. Investment tracks evidence rather than momentum — and nothing advances without the numbers to justify it.
Use-case discovery with the people who own outcomes and cycle time — clinicians and operators, not just IT.
Portfolio ranked by value, feasibility, clinical risk, and data readiness.
Pilot in one clinic, service line, or claims queue — production criteria set on day one.
EHR/claims integration (FHIR, X12), privacy hardening, and MLOps / agent-ops.
Monitoring, evals, and clinician enablement — then service line to service line.
Continue, redirect, or stop. Four gates between ideation and scale; each one is a real exit ramp, priced in from the start.
Three properties we engineer into every recommendation, architecture, and pilot — because in healthcare, patients, clinicians, and regulators all have to believe the answer.
Human-in-the-loop on consequential calls — diagnoses, denials, prior auth. Bias and neutrality testing across patient populations. Policy packs mapped to your reality: HIPAA, 42 CFR Part 2, state privacy.
For you: AI accelerates your clinicians and examiners — accountability never leaves them.
Append-only logs of every prompt, retrieval, and decision. Lineage from chart and claim to output, per user and per patient. Evidence packs for CMS audits, OIG inquiries, and accreditation surveys.
For you: When the auditor asks "why", you have the receipts.
Citations to clinical evidence, policy, and the chart on every answer. Decision traceability from output back to source and policy. No black-box recommendations in clinical or coverage decisions.
For you: No determination you can't defend — to a patient, a plan, or a regulator.
In healthcare, AI's attack surface reaches the chart — new identities, new data flows across EHRs, clearinghouses, and partners, new paths to PHI. We treat security as the first gate every recommendation must clear, not a review at the end.
Find ungoverned use in clinics and back office; convert it to protected paths.
PHI detection and de-identification, minimum necessary, and encryption throughout.
Non-human identity, scoped credentials, and full attribution of every action.
Input shielding, output filtering, and abuse and anomaly monitoring.
Your VPC or on-prem; BAA-covered services only — your keys, your residency.
Evals, red-teaming, and drift monitoring as an operating rhythm rather than an event.
Four fixed-scope engagements, each separately contracted with named deliverables. You re-decide at every gate — momentum is earned, never assumed.
Not observations — instruments. Each artifact is built to move a specific decision: fund, fix, pilot, or stop.
Where you stand — clinical and claims, scored honestly against benchmark.
Ranked by outcome and margin impact, with named owners and source systems.
A sequenced 90-day plan and 12-month arc, decision-ready.
Policies, human-in-the-loop gates, and audit posture defined before the first build.
Production criteria set from day one, with metrics, guardrails, and integration points.
Centre-of-excellence design, clinical roles, and decision rights.
Where does AI relieve clinicians or cut cycle time first — and what is it worth?
Is our clinical and claims data ready? If not, what exactly is the fix?
Can we defend AI-assisted clinical and coverage decisions to patients, plans, and regulators?
What will it cost — and when does it pay back?
Who owns AI risk — clinical and corporate — and how is it monitored?
Most AI advice comes from people who have never run a model in production — or sat through a utilization-review meeting. Ours comes from doing both.
We design, build, and operate production agentic-AI systems. Every recommendation arrives pre-tested against deployment reality.
We frame AI around clinician time, cycle time, denials, quality measures, and total cost of care — not tech for its own sake.
Provider-agnostic across Bedrock, Vertex, Azure OpenAI, and on-prem. We optimize for your outcomes, not a reseller margin.
Enablement is the deliverable: your people, your operating model, your capability — stronger after every phase, independent at the end.
One 30-minute executive session is enough to scope your readiness sprint. Two to three weeks later: an honest clinical-and-claims scorecard, a board-ready readout, and a clear decision on what comes next.
Scope a readiness sprint or email info@mteklabs.comResponsible · Auditable · Explainable · PHI-secure by design
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