Itirra

Small enough to care, big enough to get the job done

[Itirra @ItirraSeattle]

Congress is trying to block it. But WISeR is live. Waiting is not a strategy.

[Itirra @ItirraSeattle]

Three questions worth asking this quarter:

Can you pull PA denial data by service category?
Who owns the 72-hour clock in your workflow?
Do you have a BAA with every vendor in your PA chain?
Full breakdown - https://t.co/jnzh9Z5GEY

[Itirra @ItirraSeattle]

The algorithm deciding whether your Medicare patient gets approved is run by a company paid more when it says no.

That is not speculation. That is the WISeR model. It launched January 1st.

[Itirra @ItirraSeattle]

The denial doesn't start at billing.
It starts when the note is written.

If your clinical documentation doesn't carry the medical necessity rationale in a format the AI reads - the request fails before it reaches billing.

[Itirra @ItirraSeattle]

FHIR-compliant doesn’t mean AI-readable. That gap is now showing up as denied claims.

[Itirra @ItirraSeattle]

Six states. No opt-out. 72 hours. Your cash flow waits on an algorithm you didn’t hire.

[Itirra @ItirraSeattle]

The denial doesn’t start at billing. It starts when the note is written.

[Itirra @ItirraSeattle]

The algorithm is paid per denial. That’s the WISeR model.

[Itirra @ItirraSeattle]

79% of physicians offered ambient AI scribes declined to use them - not because the transcription was bad, but because the consent workflow around it didn't exist.

[Itirra @ItirraSeattle]

79% of physicians offered ambient AI scribes declined.
Not because the transcription was bad.
Because nobody built the consent workflow before switching it on.

[Itirra @ItirraSeattle]

"HIPAA-ready" describes what the model is allowed to do.
What it actually does inside your EHR depends on the integration layer built around it.

Full breakdown of all 5 touchpoints: https://t.co/snSXIlyY03

[Itirra @ItirraSeattle]

Every healthcare AI vendor says "HIPAA-ready." That's a claim about the vendor.
It says nothing about what happens once the tool is wired into your EHR, reading real patient data, in real workflows.
5 places AI is touching PHI right now and what HIPAA actually permits at each.

[Itirra @ItirraSeattle]

But it's a platform, not a configuration.
The FHIR scopes still need defining. The free-text fields still need auditing. The consent workflow still needs to exist before the ambient tool is switched on.