Prototype. What you see here is an example built to illustrate what’s possible. No real data. Every Simpliciti application is designed around your operation.

Healthcare Operations

Your patients shouldn’t wait months because a case file is sitting on someone’s desk.

Case backlogs growing. Billing codes entered by hand. Compliance documentation assembled from a dozen disconnected systems. Here is what a system built to fix that looks like.

Sound Familiar?

Where healthcare operations break down.

01

Case backlogs keep growing

Cases pile up because every one requires manual document review, data entry across multiple systems, and approvals that get stuck in email chains nobody monitors.

02

Billing is error-prone and slow

Coding and billing requires cross-referencing documentation against regulatory schedules. Manual entry means errors, rejections, and revenue left on the table.

03

Accountability is hard to prove

When oversight asks who did what and when, your team reconstructs the timeline from emails, file timestamps, and memory. There’s no single system of record.

Case Management

Imagine every case tracked from intake to resolution.

The application we build manages the full case lifecycle: intake, document processing, eligibility determination, assignment, review, and resolution. Caseworkers see their caseload, supervisors see the pipeline, and leadership sees the metrics — all in one place.

DemoCasesPatientsAuthorizationsProvidersReportsSettingsAMAngela MartinezCase ManagerCasesCM-2026-0491Care PlanRobert Hernandez — Post-Surgical Care CoordinationPRODUCTIONCM-0491ActiveUpdate Care PlanSummaryCare PlanAuthorizationsProvidersNotesActivityRHRobert HernandezDOB: 04/12/1958 · MRN: 2026-049182 · Medicare + Blue Cross supplementDx: Right hip replacement (ICD-10: Z96.641) · Surgery: Feb 18, 2026✦ AI Care Plan72%care plan milestones metPost-Surgical MilestonesWEEK 1 — ACUTE RECOVERYCompletePost-op assessment completedDr. Rivera · Feb 19Pain management protocol initiatedSystem · Feb 18PT evaluation scheduled and completedAI scheduled · Feb 20Home health referral submittedAI submitted · Feb 21WEEK 2–4 — REHABILITATIONIn ProgressPT sessions 3x/week — 4 of 9 completedTrackingHome health nurse visits — 2 of 4 completedTrackingWound care check — scheduled Mar 8AI scheduled2-week follow-up with surgeonPending schedulingDME equipment return assessmentPending!PT authorization expires in 5 days — 5 sessions remainingAI flagged: Current auth covers 9 visits through Mar 11. Re-authorization needed for continued therapy.SOURCE DOCUMENTSSurgical-notes.pdfOp ReportPT-eval-Feb20.pdfPT EvaluationAuth-BC-2026.pdfPrior AuthHH-referral.pdfHome HealthStatusProvidersAuthActivityCare TeamDMRDr. Maria RiveraOrthopedic SurgeonPrimaryJTPJake Thompson, PTPhysical TherapistActiveSWRSandra Wells, RNHome Health NurseActiveAMAngela MartinezCase ManagerAssignedACTIVE AUTHORIZATIONSPhysical Therapy9 visits · 4 used · Exp: Mar 115 remainingHome Health Nursing4 visits · 2 used · Exp: Mar 182 remainingDME — Walker30 days · 16 days · Exp: Mar 20ActiveAI RISK INDICATORSReadmission risk: Moderate (18%)Based on age, procedure type, and comorbiditiesPT auth expiration in 5 daysRe-authorization form pre-filled by AIMedication adherence: On trackPharmacy refill confirmed Feb 28HIPAA compliance: All records securedUpdate Care PlanRequest Re-AuthEscalate Case

Billing & Coding

What if your billing team only touched exceptions?

The application we build reads case documentation, identifies billable services, assigns appropriate codes, flags discrepancies, and routes claims for review. Your billing team focuses on exceptions and approvals, not manual code lookups.

DemoEncountersClaimsDenialsProvidersReportsSettingsTPTeresa PhamCertified CoderEncountersENC-2026-7842Code ReviewEncounter #7842 — Dr. Patel, Cardiology · Patient: Margaret TorresPRODUCTIONENC-7842Needs CodingSubmit to PayerClinical NotesAI Suggested CodesPayer RulesHistoryPatient:Margaret Torres, 72FProvider:Dr. Anand Patel, CardiologyDOS:Feb 27, 2026Payer:Medicare Part BVisit Type:Follow-up, Established PatientAI CodedDiagnosis Codes (ICD-10)CODEDESCRIPTIONSOURCECONFIDENCEI25.10Chronic ischemic heart diseaseClinical Note p.198%I48.91Atrial fibrillation, unspecifiedClinical Note p.196%E11.9Type 2 diabetes without complicationsMedication List94%I10Essential hypertensionVitals + History97%Z79.01Long-term use of anticoagulantsMedication List92%R00.1Bradycardia, unspecifiedECG Results78%!R00.1 (Bradycardia) — confidence below threshold (78%)ECG shows rate of 58 bpm. Verify if clinically significant for this encounter or if it's baseline for patient.Procedure Codes (CPT)99214Office visit, established, moderate complexityUnits: 197%93000Electrocardiogram, 12-lead, with interpretationUnits: 199%93798Cardiac rehab monitoring (if applicable)Units: 172%SOURCE DOCUMENTSClinNote-Patel.pdfClinical NoteECG-027842.pdfECG ResultsMedList-Torres.pdfMedication ListPrevVisit-Jan26.pdfPrior EncounterClaim SummaryPayer RulesActivityClaim AssemblyTotal ChargesExpected Reimbursement$487.00$312.406 Dx codes · 3 CPT codesBased on Medicare fee schedulePAYER RULES CHECKMedical necessity: Supported by documentationNo bundling conflicts detectedModifier requirements: None needed93798 may require prior authorizationMedicare Part B typically requires auth for cardiac rehabTimely filing: Within window (DOS + 365 days)AI DENIAL RISK ASSESSMENTLow Risk8% estimated denial probabilityCODING STATSCodes suggested9 codesfrom 4 docsAvg confidence93.1%2 flaggedCOMPLIANCEHIPAA: Protected health info securedOIG compliance: No excluded providersCoding accuracy audit: Within guidelinesSubmit Claim to PayerHold for ReviewQuery Provider

Your Timeline

From first conversation to live application.

This is how an engagement with a team like yours typically runs. Every system is different — this gives you a sense of what to expect.

Weeks 1–2

We map your clinical operations pipeline

We sit with caseworkers, billing staff, and compliance to understand how cases, claims, and approvals actually flow through your organization.

Weeks 3–8

We build around your compliance requirements

Your case types, your approval chains, your regulatory requirements, your billing rules — encoded into a system with full audit trails and automated compliance checks.

Weeks 9–12

Your team goes live

We onboard every role — caseworkers, billing staff, supervisors, compliance officers — and stay with you as the system learns your operation.

Ready to fix your healthcare operations pipeline?

Tell us about the process creating the most risk or the longest delays in your operation. We will show you what a system built around it could look like.