Evidence to access · every orthopaedic service line
Turn a hardware finding into anapproval-ready human workflow.
Synorthopic can now prepare the documentation, coding-catalog, eligibility, and prior-authorization work that follows a reviewed implant-removal plan—from adult trauma and staged infection care to pediatric growth and chest-wall constructs.
The software prepares; people decide. A treating clinician owns the plan, a coder confirms codes, and authorized staff submit to the payer.
Interactive synthetic cases
Prepare the next administrative move.
These examples contain no patient identifiers and make no reimbursement or medical-necessity claim.
ADULT-ANK-914 · Plate & screw fixation
Planned removal of deep right-ankle hardware
An explicit surgeon plan and localized indication are present. The fictional payer requires imaging and laterality documentation.
DocumentationHuman review ready
Coverageactive
Requirementsrequired
Documentsassembled
Human submitdraft prepared
Payer responseexternal system
A
8/8 suppliedDocumentation packet
- ✓Requested serviceExact quote retained in source workspace
- ✓Treating-clinician planExact quote retained in source workspace
- ✓Documented indicationExact quote retained in source workspace
- ✓Hardware identityExact quote retained in source workspace
- ✓Body siteExact quote retained in source workspace
- ✓Lifecycle evidenceExact quote retained in source workspace
- ✓LateralityExact quote retained in source workspace
- ✓Supporting imaging/reportExact quote retained in source workspace
B
Human coder requiredCoding review
Fictional local candidateDEMO-HW-REMOVAL
Fictional local candidate · implant-removal service
5 evidence IDs · deterministic rule DEMO-RULE-HARDWARE-REMOVALPrivate CPT boundary
Synorthopic never needs your SpineCPT license key or full code library. A customer-controlled adapter returns only bounded candidates for this case, and a human coder still makes the final assignment.
SpineCPT private bridgeImplemented local handoff
Library not sharedExport an evidence-ID-only request, run it beside your licensed library, then return at most eight candidates. Nothing is transmitted by this page.
No SpineCPT data is loaded. Download a patient-free request, run it inside your licensed environment, then load only the per-case response.
Using the fictional local demonstration catalog.
C
PreparedAgent preparation
- evidence inventory
- documentation gap check
- customer catalog rule match
- authorization route selection
- coding handoff preparation
Connection truth
What is local, what is only planned, and what still needs customer proof
Local evidence preparation and bounded file contracts do not establish a payer, EHR, coding-provider, repository, messaging, or calendar connection. Every external read, response, or write remains disabled until its own evidence gate passes.
Implemented3Tested local code paths
Concept7Documented boundaries only
Sandbox or higher0Dated external proof required
Live customer connections0No configuration-inferred status
External writes0Production authorization required
EHR readImplemented
SMART interactive chart-context read
A read-only SMART chart-context flow is implemented and synthetic-tested; no customer EHR is registered, connected, or verified.
- Standard
- SMART App Launch + FHIR R4
- Version
- SMART App Launch 2.2.0
- Current runtime
- Synthetic only
- Direction
- Read
Current boundary
The authorization and read path is synthetic-tested; no customer app registration, credentials, chart launch, or live FHIR read exists.
Local evidence
- Authorization Code with PKCE S256
- State, issuer, redirect, and replay checks
- Read-only scope enforcement
- Bounded token and FHIR response handling
Still required
- customer registration
- customer endpoint configuration
- least privilege authorization
- mapping and conformance
- positive control canary
- data completeness study
- privacy security approval
- clinical operational approval
- monitoring and rollback
CodingImplemented
Private SpineCPT candidate handoff
A patient-free private SpineCPT handoff contract is implemented; the licensed engine is not bundled, connected, or publicly verified.
- Standard
- Synorthopic SpineCPT private-provider contract
- Version
- lookup request/response v1
- Current runtime
- Local exchange only
- Direction
- Local exchange
Current boundary
No SpineCPT source, license key, terminology library, live service, or proprietary descriptor is present in this repository.
Local evidence
- Patient-free request schema
- Request-bound response validation
- Candidate and file-size limits
- Licensed-content rejection
- Human final-code authority
Still required
- customer registration
- mapping and conformance
- positive control canary
- privacy security approval
- clinical operational approval
- licensed content authorization
- monitoring and rollback
CodingImplemented
Synorthopic human coding review handoff
A de-identified evidence-linked coding handoff is implemented; a qualified human selects every final code.
- Standard
- Synorthopic evidence-ID-only coding handoff
- Version
- orthoscrub.synoptic-coding-handoff.v1
- Current runtime
- Local exchange only
- Direction
- Local exchange
Current boundary
The handoff is a local de-identified artifact; no coding system, EHR charge router, or billing system is connected.
Local evidence
- Evidence-ID-only serialization
- Documentation-gap separation
- Human final-code authority
- No licensed descriptors
Still required
- customer registration
- mapping and conformance
- positive control canary
- privacy security approval
- clinical operational approval
- licensed content authorization
- monitoring and rollback
PayerConcept
Prior-authorization evidence exchange
Prior-authorization packet preparation is local; no payer transport, policy service, submission, or response integration is implemented.
- Standard
- Da Vinci CRD/DTR/PAS/CDex or X12 278
- Version
- PAS 2.2.1; customer-profiled companion guides
- Current runtime
- Not connected
- Direction
- Request / response
Current boundary
Local packet preparation does not implement payer policy retrieval, attestation, submission, response, or medical-necessity determination.
Local evidence
- Criterion-by-criterion evidence matrix
- Documentation-gap detection
- Attachment manifest
- Human submission gate
Still required
- customer registration
- customer endpoint configuration
- least privilege authorization
- mapping and conformance
- positive control canary
- privacy security approval
- clinical operational approval
- monitoring and rollback
PayerConcept
Eligibility and benefits exchange
An eligibility adapter boundary is documented; no clearinghouse or payer eligibility connection is implemented.
- Standard
- X12 270/271 or approved eligibility API
- Version
- Customer-licensed implementation guide
- Current runtime
- Not connected
- Direction
- Request / response
Current boundary
No eligibility request is transmitted and no displayed synthetic benefit state is a coverage verification or guarantee.
Local evidence
- Eligibility request and response domain contract
Still required
- customer registration
- customer endpoint configuration
- least privilege authorization
- mapping and conformance
- positive control canary
- data completeness study
- privacy security approval
- clinical operational approval
- monitoring and rollback
PayerConcept
Coder-approved claim handoff
A claim-handoff boundary is documented; Synorthopic performs zero claim or clearinghouse submissions.
- Standard
- X12 837 or customer billing-system contract
- Version
- Customer-licensed implementation guide
- Current runtime
- Not connected
- Direction
- Write
Current boundary
No claim creation, charge posting, clearinghouse submission, correction, or account adjustment is implemented.
Local evidence
- Evidence-ID-only coding handoff
Still required
- customer registration
- customer endpoint configuration
- least privilege authorization
- mapping and conformance
- positive control canary
- privacy security approval
- clinical operational approval
- monitoring and rollback
PayerConcept
Claim status exchange
A claim-status adapter boundary is documented; no payer or clearinghouse status exchange is implemented.
- Standard
- X12 276/277 or approved clearinghouse API
- Version
- Customer-licensed implementation guide
- Current runtime
- Not connected
- Direction
- Request / response
Current boundary
No clearinghouse or payer endpoint is connected; synthetic status labels are not payer responses.
Local evidence
- Claim-status handoff contract
Still required
- customer registration
- customer endpoint configuration
- least privilege authorization
- mapping and conformance
- positive control canary
- data completeness study
- privacy security approval
- clinical operational approval
- monitoring and rollback
EHR readConcept
Enterprise document repository
An enterprise-document adapter boundary is documented; no customer repository is connected.
- Standard
- Customer-approved document repository API
- Version
- Customer-specific
- Current runtime
- Not connected
- Direction
- Request / response
Current boundary
No SharePoint, Box, Drive, or other enterprise document tenant is connected.
Local evidence
- Document reference and attachment-manifest contracts
Still required
- customer registration
- customer endpoint configuration
- least privilege authorization
- mapping and conformance
- positive control canary
- privacy security approval
- clinical operational approval
- monitoring and rollback
CommunicationsConcept
Workforce review notifications
A workforce-notification boundary is documented; no customer channel is connected and no message is sent.
- Standard
- Customer-approved messaging or email API
- Version
- Customer-specific
- Current runtime
- Not connected
- Direction
- Write
Current boundary
No Teams, Slack, email, SMS, voice, or other notification channel is connected; no patient outreach is permitted.
Local evidence
- Human-reviewed notification intent contract
Still required
- customer registration
- customer endpoint configuration
- least privilege authorization
- mapping and conformance
- positive control canary
- privacy security approval
- clinical operational approval
- monitoring and rollback
CommunicationsConcept
Administrative reminder calendar
A calendar adapter boundary is documented; no customer calendar is connected and no reminder is created.
- Standard
- Customer-approved calendar API
- Version
- Customer-specific
- Current runtime
- Not connected
- Direction
- Write
Current boundary
No calendar transport, customer identity mapping, reminder creation, patient contact, or appointment booking is implemented.
Local evidence
- Human-reviewed reminder intent contract
Still required
- customer registration
- customer endpoint configuration
- least privilege authorization
- mapping and conformance
- positive control canary
- privacy security approval
- clinical operational approval
- monitoring and rollback
Automation truth
Revenue-cycle rules operating envelope
The local engine prepares documentation gaps and bounded candidates. It does not contain licensed CPT content, select a final code, determine medical necessity or coverage, submit a transaction, or write to an EHR.
Generative boundaries0Untrusted proposal paths
Deterministic engines1Extractors, verifiers, rules, and policies
Enabled model calls0Public release truth
Customer data enabled0Requires customer proof
External actions0Production authorization required
Online learning0Prohibited by current policy
Deterministic rulesetImplemented
Revenue-cycle preparation rules
Deterministic revenue-cycle preparation is implemented and synthetic-tested; coding, medical necessity, coverage, and submission remain human and external-system responsibilities.
- Contract
- orthoscrub.revenue-cycle-packet.v1
- Engine
- Repository deterministic code
- Identifier
- revenue-cycle-preparation
- Current runtime
- Synthetic fixture
- Release decision
- local demo only
- Test dataset
- revenue-cycle-synthetic-fixtures.v1
Human gate
A qualified coder, biller, or clinician reviews the packet and owns every final decision and submission.
Inspect controls and operating envelope
Deterministic checks
- Evidence-ID citation
- Catalog allowlist
- Candidate and input limits
- Human authority markers
Abstains when
- Missing reviewed evidence
- Unsupported catalog candidate
- Unmet payer evidence
Prohibited actions
- Final coding
- Medical-necessity decision
- Claim or authorization submission
- EHR write
Evaluation state
- Subgroups: not applicable
- Overrides: local test only
- Incidents: not established
- Rollback: Export the reviewed evidence without generated coding or payer preparation.
Non-negotiable boundary
Automate the paperwork, not the judgment.
- Assemble reviewed evidence IDs
- Expose missing documentation
- Match deterministic customer rules
- Route to the correct integration
- Track external administrative status
- Clinical plan and medical necessity
- Final code and modifier assignment
- Prior-authorization attestation
- Claim submission and correction
- Appeal strategy and signature