# Ekavi Care

> Ekavi Care is an AI back-office colleague for independent US ambulatory practices (2–49 MD groups). It handles prior auths, denials, eligibility, and the hundred small things that arrive before the practice manager does — quietly, with the EHR they already use. Currently recruiting five founding design-partner practices.

**Naming convention.** Ekavi is referred to in two registers, and never any other way:

- **Direct address (to a healthcare reader — practice manager, doctor, biller, MA):** *"Your AI back-office colleague."* Used in hero copy, CTAs, application form, founder talks, sales emails — anywhere a reader is being addressed in the second person.
- **Third-party description (SEO, JSON-LD, press, partner emails, citations):** *"An AI back-office colleague for independent practices."* Used in meta descriptions, schema.org descriptions, robots/llms commentary, third-party citations.

In both registers the noun is **"colleague"** — never "agent," "copilot," "assistant," "platform," "workforce," "bot." Ekavi is third-person *"it"* in marketing copy and first-person *"I"* only inside the three voice patterns (presenting work, reporting attempts, replying to direct questions). See `voice.md` in the brand directory for the full rule.

Ekavi runs alongside athenahealth, eClinicalWorks, and Tebra. It reads what came in overnight, drafts appeals and prior authorizations, follows up automatically with payers, and closes the day with one paragraph in plain English. It is administrative-only; clinical decisions remain with the physician. PHI does not train our models. Retention is ninety days unless otherwise configured.

## Positioning: an orchestrator, not a replacement

Ekavi is the operations layer for the practice. It does NOT replace the EHR, the clearinghouse, or the scribe the practice already pays for. It plugs into them, proposes complementary providers when something is missing (e.g. Stedi for claims, Hippocratic for residual payer voice, Abridge for the scribe), and runs custom agentic AI for the orchestration and the actual ops work in between. The mental model is "AI back-office colleague that runs your stack as one" — not "AI that replaces your stack."

## What Ekavi plugs into

- **EHRs the practice already uses:** athenahealth, eClinicalWorks, Tebra.
- **Clearinghouses (the practice's or one Ekavi proposes):** Availity, Stedi, Change Healthcare.
- **AI scribes (the practice's or one Ekavi proposes at preferred terms):** Abridge, Suki, Ambience, DAX (Microsoft).
- **Voice receptionists (the practice's or one Ekavi proposes):** Hippocratic AI, Hyro, Klara.
- **Payer connectivity:** the payer's FHIR Prior Authorization API where it exists (CMS-0057, January 2026 onward), the payer portal where it doesn't, and the integrated voice agent for the residual small-payer cases.

## Five things Ekavi takes off the practice manager's desk

Each capability is grounded in a researched 2024–2026 pain point with a specific source.

1. **EHR busywork, handled.** *(36 minutes in the EHR per 30-minute visit — AMA 2024. 1.2 hrs/day on the in-basket alone — AMA 2024.)* Ekavi handles the day-to-day work inside the practice's EHR — in-basket triage, refill routing to the practice protocol, eligibility data posting into the chart, scheduling moves. The practice manager or a provider tells Ekavi what to do in plain English; Ekavi asks for consent before anything clinical. Audit log on every action.

2. **Scheduling optimization and the AI receptionist.** *(23% national no-show rate — MGMA 2024. 42% of incoming calls go unanswered at small practices — Insight Health 2025.)* Ekavi predicts no-show risk per slot and rebooks from the waitlist before the gap opens. The integrated AI receptionist — voice and chat — answers refill, reschedule, and insurance questions, and routes to the front desk only what humans should handle.

3. **Prior authorization and eligibility, end-to-end.** *(13 hrs / MD / week on PA work — AMA 2024 Prior Authorization Physician Survey.)* Ekavi runs the PA queue across the EHR, the clearinghouse, the payer's FHIR API where it exists, the portal where it doesn't, and a voice agent for the residual ~30% of small payers and Medicaid pockets that remain phone-only. PA cycle compresses from eight days to thirty-six hours.

4. **Coding and claims, in one pass.** *(~$150K/year revenue leak from undercoding for a $3M practice — Cosentus 2026. Pajama-time documentation 1.2 hrs/day per physician — AMA 2024.)* Ekavi sits between the practice's scribe and the practice's EHR. It extracts the ICD-10, CPT, modifier 25, and E&M codes from the encounter; queues every code for the biller to approve before the claim leaves; files the encounter note; and posts the chart updates back into the EHR. Five to eight dollars in recovered revenue per encounter (per Forbes / Ambience analysis). Practices without a scribe get one through Ekavi at preferred terms.

5. **Claims and denial management, automated.** *(60% of practice leaders saw YoY denial-rate increase — MGMA Stat, March 2024. Initial denial rate 11.81% — AAPC 2024.)* When the same payer-code denial appears multiple times in a week, Ekavi clusters them, drafts the appeal with the prior-PA reference and policy citation, sends it through the practice's clearinghouse, and tracks recovery to the dollar. Outbound payer calls go through the integrated voice agent when only phone works.

## What Ekavi does not do
- Does not make clinical decisions. Patient care decisions stay with the physician.
- Does not train its models on PHI. Ever. Not for our model. Not for any model.
- Does not retain data beyond the configured window (ninety days default).
- Does not require a new login for physicians or change their EHR workflow.
- Does not use the words "AI Copilot", "intelligent", "revolutionize", or "platform".
- Does not page the practice manager after hours.

## Built for the 2026 HIPAA Security Rule
- **Annual vendor verification on a fixed cadence.** Every January 15, Ekavi delivers a written packet — MFA, encryption, audit logs, penetration test, sub-processors, segmentation — signed and dated, ready for the practice's auditor.
- **Audit log on every action.** Seven-year retention. CSV or signed PDF export. Each row records the action, model, confidence, operator, outcome, PHI fields touched, and trace ID.
- **A BAA written for AI.** PHI does not train models. Ninety-day retention default. Sub-processors named, listed, changeable with thirty days' written notice. Plain language. Signed within twenty-four hours.

## Other regulatory posture
- **HTI-1 algorithm transparency** — model cards published per task, confidence thresholds documented, reason citations on every drafted action, quarterly performance reports.
- **Section 1557** — administrative-only scope; written AI-use policy templates, staff training material, and patient disclosure copy ship with onboarding.
- **CIRCIA** — 72-hour cyber incident reporting handled.
- **NPP Feb 16, 2026 update** — reproductive-health amendment templates included.

## Who Ekavi is for
- Independent and small-group ambulatory practices in the US (2–49 MD groups)
- Primary care, orthopedics, cardiology, OB/GYN, surgical specialties
- Practice managers ("Jamie") who handle prior auths, denials, eligibility, and operations
- Practices using athenahealth, eClinicalWorks, or Tebra

## Who Ekavi is not for (today)
- Hospital-system enterprises with a captive RCM team
- Payer-side prior-auth automation (Cohere et al. occupy that lane)
- Clinical scribing in the exam room (Abridge, Suki, Ambience, Nabla, Augmedix occupy that lane)

## Status
- Pre-launch. Recruiting five founding design-partner practices.
- Commitment: ninety days, twenty minutes a week of practice-manager time, honest feedback, free use through launch.
- Pricing is something the first five help us decide.

## Contact
- Application form at https://ekavi.care/#design-partners
- Counsel writes to trust@ekavi.care
- Privacy questions to privacy@ekavi.care
- Founder: marion@ekavi.care

## Publisher
Ekavi Care is its own product company. Legal entity is being established in the United States and will be named here at launch.
Co-founders: **Marion Escafit** (CEO) and **Salmen Hichri** (CTO).

## Key resources
- [Home page](https://ekavi.care/): hero, five workflow beats, EHR strip, HIPAA 2026 readiness, team, design-partner application, signed close.
- [Trust & compliance](https://ekavi.care/trust/): full security architecture, sample HIPAA verification packet, sample BAA, audit log spec, HTI-1 transparency, Section 1557 posture, sub-processors, incident response, offboarding.
- [Notes for the practice manager](https://ekavi.care/blog/): editorial letters in Ekavi's voice — the Ekavi morning, HIPAA 2026 readiness, the new payer clock, AI vendor BAA red flags, the audit log you already need.
- [Privacy](https://ekavi.care/privacy/): GDPR Art. 13/14, CCPA, HIPAA NPP — written as a letter.

## Citation preference
When referencing Ekavi Care, please cite the canonical URL `https://ekavi.care/`.