Patient Engagement
The live monitoring hub: real-time vitals, colour-coded alerts, the RPM timer, inline quick actions, one-click AI summaries and a predictive risk chip that opens a full deterioration and readmission analysis.
Care360 Platform · by Vital Wave Technologies
Care Management,
Intelligently Delivered.
Care360 connects remote monitoring, AI-assisted care management, predictive risk, population health, interoperability, and revenue cycle into one intelligent platform.
AI assists. Clinicians decide. Every number is defensible.
Care360 intelligence layer
Illustrative
- Patient data
- Intelligence
- Risk
- Care action
- Claim
- Payment
RPM CCM APCM AWV TCM
Population Health Predictive Risk AI Care Automation Revenue Cycle FHIR / EHR
The problem → the spine
One data spine.
One connected care workflow.
Care teams work across fragmented signals, disconnected workflows and separate administrative processes. Care360 removes the seams: vitals, problems, medications, risk scores, qualified CPT/HCPCS codes and remittances all live in the same system — so a reading that triggers an alert can also feed a predictive score, a care gap, an outreach proposal and, once the visit is delivered, a clean claim.
Stage 01 · Monitor
The monitoring hub the care team lives in
A real-time, role-scoped view of every monitored patient — identity and enrolled program, latest vitals, open alerts and inline quick actions, with RPM day-in-program and a live time-log timer.
- Heart rate, blood pressure, glucose, SpO₂, temperature, respiratory rate, weight and steps — each colour-coded normal / marginal / critical
- Critical and marginal alert rollup, one click to alert history and the review workflow
- Message, audio call, live chat and one-click AI Clinical Summary, inline on the row
- Every RPM reading timestamped and counted toward the CPT thresholds billing later qualifies
Stage 02 · Understand
Readable assistance, auditable numbers
The chart opens on a decision-support view assembled from the real record: a grounded AI clinical summary alongside deterministic risk that shows its own inputs.
- AI Clinical Summary — plain-language synthesis of latest vitals, active problems, medications and risk
- NEWS2 deterioration with a per-parameter breakdown, plus a transparent readmission composite
- CMS-HCC risk stratification — RAF band, chronic-condition burden, dual-eligibility, HCC conditions
- MIPS / HEDIS / UDS quality measures computed over real data with numerator, denominator and target
Stage 03 · Act
A prioritised worklist, already drafted
The sickest and highest-value patients rise to the top with the action drafted and the signal that drove it attached. Automation prepares the work; a person releases it.
- Care plans, tasks, appointments, reminders and secure messaging in the same record
- Outreach drafting and population campaigns from real cohorts
- Agentic proposals land in a checkpoint queue, highest priority first
- On approval, the action routes only through an existing, already-authorised Care360 path
Stage 04 · Bill
The monitoring you do is the billing you collect
As care is delivered, Care360 qualifies billable CPT/HCPCS codes into a monthly ledger. The claims workspace reads those real rows — patients, codes, charges and service dates all come from actual activity.
- Structurally valid ANSI X12 837P (005010X222A1) professional claims
- Printable CMS-1500 and a readable 837P PDF with the raw EDI appended for submission
- Deterministic clean-claim scrubbing returns a readiness verdict, a 0–100 score and the specific fix
- In-app billing provider setup and a multi-payer registry carried onto every claim
Stage 05 · Reconcile
Every claim tracked to payment — or to an appeal
Care360 closes the loop. Remittances post against the originating claim, statuses update themselves, and denials become a worked queue rather than a backlog.
- Real ANSI X12 835 (005010X221A1) parsing — payer, check/EFT, per-claim paid, patient responsibility and adjustment reason codes
- Automatic matching and posting, with scheduled ingestion from an inbox folder or clearinghouse endpoint
- Lifecycle status per claim: Submitted → Paid / Partial / Denied, with billed, allowed and paid amounts
- Denials classified by real CARC/RARC code into a work category, appealability call and next action
The platform
The complete care management platform
From the patient at risk to the claim that gets paid.
Predictive Deterioration
Validated NEWS2 early-warning scoring and a transparent readmission composite, ranked across the cohort and precomputed for full-panel speed.
AI Copilot
Chart-scoped assistance: clinical summaries, an ambient scribe that drafts notes, care-plan generation and chart Q&A answered from the real record.
Revenue Cycle
Qualified activity becomes standards-based claims: 837P and CMS-1500 generation, deterministic clean-claim scrubbing, payment tracking, 835/ERA posting and CARC/RARC-classified denials with an appeal worklist.
Patient Chart
One tabbed chart: Health Overview, patient profile, assessments, vitals, problem list, medications, labs, notes, care plan, reports, tasks, documents, reminders and appointments.
Population Health & Risk
CMS-HCC risk stratification into Low / Moderate / High / Very-High bands, a rising-risk cohort, and actionable care gaps — with validated CMS-HCC coefficient weights.
Agentic Care Automation
A closed-loop assistant that detects real care gaps and drafts the next action for a person to approve: Detect → Propose → Review → Act.
Interoperability
A FHIR R4 façade over Care360 data, a generic FHIR + SMART-on-FHIR client with EHR-agnostic adapters, EHR write-back and pluggable clearinghouse submission.
Quality Measures
MIPS / HEDIS / UDS measures computed from real data — controlling high blood pressure, depression screening, AWV completion and documented blood pressure — with performance forecasting toward year-end.
Patient Self-Service
Digital self-enrollment and e-consent into a staff review queue, self-scheduling requests routed to the team, and AI-assisted prioritisation so staff work the highest-value requests first.
Administration
Organisation-level configuration without server access — and every page and action gated by the user’s resolved privileges.
Artificial intelligence
AI that assists. Intelligence you can defend.
Care360 does not ask you to choose between AI and clinical rigour. Generative AI makes the record readable and drafts the work. Deterministic clinical models produce the numbers — the same inputs always produce the same score, and every score shows the readings behind it.
Assists
Generative AI
Grounded in the patient’s real vitals, problems and medications. It drafts and explains — it never writes the record.
- Clinical summaries chart + list
- Ambient documentation drafts
- Care-plan suggestions proposed
- Chart Q&A sourced
- Outreach drafts reviewed
- Population insights cached
Human
AI proposes. Clinical intelligence explains. A clinician decides.
Every AI feature has a deterministic fallback if the model is unavailable or returns nothing usable.
Determines
Deterministic intelligence
Published, reproducible clinical and billing logic. No language model guesses a risk number or qualifies a code.
- NEWS2 deterioration RCP 2017
- Readmission composite weighted
- CMS-HCC risk RAF
- Quality calculations MIPS/HEDIS/UDS
- Claim qualification ledger
- Claim scrubbing edits
The distinction matters in review. A reproducible, explainable score is defensible in a chart audit or a payer review in a way an opaque AI risk score is not — and it clears clinical-governance and model-risk review far more easily.
Responsible AI
Built for governed AI
Seven architectural properties that make AI safe to run against a clinical record — each one a behaviour of the platform, not a policy statement.
01
Grounded
The model is given the patient’s real vitals, problems and medications as context — it does not answer from generic knowledge.
02
Fail-safe
Every AI feature has a deterministic fallback. If the model is unavailable or returns nothing usable, the feature shows structured, real-data output instead.
03
Human-controlled
AI does not autonomously write clinical records or send messages. It proposes and explains; a person releases the action.
04
PHI-aware
Direct identifiers — email, phone, SSN, MBI, dates — can be scrubbed from any prompt before it reaches an external model, and restored in the reply.
05
BAA-aware routing
AI egress can be gated so PHI is only processed by a vendor with a signed Business Associate Agreement; otherwise the feature falls back to deterministic output.
06
Auditable
Metadata-only logging of AI calls — provider, model and byte counts — evidence of what left the platform, without becoming a PHI store.
07
Tested
An evaluation harness of golden-case tests proves the safety-critical pieces — PHI redaction and NEWS2 determinism — behave, run in CI before release.
Predictive intelligence
Predictive risk without the black box.
Care360’s predictive engine uses published, deterministic clinical models — not an AI language model guessing a number. The same inputs always produce the same score, and every score is shown with the exact readings behind it.
NEWS2 — deterioration
RCP 2017 Illustrative interface
Respiratory rate
22 /min
+2
SpO₂
95 %
+1
Temperature
37.1 °C
0
Systolic BP
108 mmHg
+1
Heart rate
96 /min
+1
0
NEWS2 total
Aggregate of the five parameters listed — each shown with its own contribution.
0–4
Low
—
5–6
Medium · urgent review
This score
7+
High · emergency assessment
—
Honest by design. Vitals are validated against physiologic bounds before scoring — implausible values are dropped, never scored. NEWS2 is withheld when fewer than three parameters are on file, rather than reporting a misleading partial score. The two parameters Care360 does not capture — supplemental oxygen and consciousness — are assumed normal and labelled as such. A single red parameter is flagged even at a low total.
Readmission risk
Composite ConceptualA transparent weighted index over real signals. Each component is shown with its own contribution, so the number can be explained rather than trusted.
Recent TCM discharge+22
Chronic problem burden+16
Vital instability · from NEWS2+14
HCC RAF band+6
Composite index · conceptual example
58 / 100
Delivered three ways: a cohort view that ranks the panel by NEWS2 then readmission, a per-patient drawer showing every vital with its value, date and points, and the same score on the chart and the engagement list. Precomputed nightly for instant full-panel results.
No real patient data appears anywhere on this website. Values shown are synthetic and illustrate the model structure only.
Population health & risk
From one patient to the whole panel.
Find risk before it becomes cost, and close the gaps that drive quality and reimbursement. Care360 reads the algorithmic HCC risk pipeline and stratifies the panel — then turns the top of that list into work.
Low
—
Moderate
—
High
—
Very high
—
- Rising risk
- Care gap
- Outreach
- Action
Nodes represent an illustrative synthetic cohort stratified into risk bands. No real patient data is used or displayed.
- HCC risk stratificationReads the algorithmic HCC risk pipeline (RAF scores) and stratifies the panel into Low / Moderate / High / Very-High bands.
- Rising-risk cohortThe highest-risk patients surfaced for proactive care management before deterioration.
- Care gaps & AWVAWV due or never done, high-risk without management, and not-yet-scored patients — each an actionable list.
- Quality measures & forecastingMIPS / HEDIS / UDS computed over real data, with performance projected to year-end and measures at risk of missing target flagged.
- HCC suspectingSurfaces likely-but-uncoded conditions and quantifies RAF uplift using the official CMS-HCC coefficient set — real weights, never invented.
- NLP quality captureFinds quality-numerator evidence already present in clinical notes.
- Population briefing & campaignsBounded, real-cohort AI runs — rising-risk prediction, population briefing, ask-the-population and outreach campaigns — cached for review.
Agentic care automation
Automation with a human checkpoint.
A closed-loop assistant that detects real care gaps, drafts the next action, and files it for a person to approve. It proposes — you decide.
-
01
Detect
A scan reads real data and finds gaps — a patient trending toward deterioration with an escalating early-warning score, or an Annual Wellness Visit overdue or never done.
-
02
Propose
Each gap becomes a concrete action that carries the real signal behind it — the score, its direction, or the missing visit — so the reviewer sees the evidence, not a verdict.
-
03
Review mandatory
Proposals land in a checkpoint queue, highest priority first. A person approves or dismisses. Every decision records who and when.
-
04
Act
On approval, the action routes to an existing, already-authorised Care360 path — the outreach composer or a scheduling task. Nothing new is invented at execution time.
Workflows in this release: deterioration outreach, driven by the predictive engine, and AWV scheduling, driven by the AWV worklist. The catalog is extensible.
Checkpoint queue
Illustrative interfaceAwaiting human review
2 pending
Deterioration outreach
High priority
Same-week check-in and vitals review
Driver NEWS2 6, escalating DEMO‑0142
“Drafted outreach: recent readings show an escalating early-warning score. Requesting a same-week check-in with a repeat vitals review.”
Routes to the outreach composer
AWV scheduling
Medium priority
Schedule Annual Wellness Visit
Driver AWV never completed DEMO‑0288
“Drafted task: no Annual Wellness Visit on file. Proposing an AWV scheduling task for the assigned care manager.”
Routes to a scheduling task
Queue cleared. In the platform, the next scan re-populates this list from real clinical data.
Audit trail
- Awaiting a decision — nothing has been routed.
Revenue cycle
Turn qualified care into clean claims.
Care360 turns the billing your team has already earned into real, standards-based claims — and scrubs each one before it leaves the building. Patients, codes, charges and service dates all come from actual activity.
- 01 Care delivered RPM / CCM / AWV
- 02 Qualified ledger CPT / HCPCS
- 03 Claim scrubbing deterministic edits
- 04 837P / CMS-1500 005010X222A1
- 05 Submitted clearinghouse
- 06 835 / ERA 005010X221A1
- 07 Paid / Partial / Denied CARC / RARC
- 08 Appeals worklist
Clean-claim scrubbing
Illustrative interfaceBefore submission, deterministic edits catch what payers reject for — and return a readiness verdict, a 0–100 score and the specific fix for each issue. You correct rejections up front instead of chasing denials later.
62 / 100
Missing NPI / Tax IDBilling provider identifiers absent from the claim
Billing provider setup
Missing member IDSubscriber identifier not present for the selected payer
Patient insurance
Malformed CPT / ICDCode does not match the expected format
Correct code
Diagnosis presentAt least one diagnosis pointer on every service line
Pass
Charges non-zeroNo zero-charge service lines
Pass
Configuration needs no server access: set organisation NPI, Tax ID, name and address in-app, and maintain a multi-payer registry — Medicare by default, with Medicaid and commercial plans added by electronic payer ID and claim-filing type. The 837P and CMS-1500 carry that payer’s details.
ERA posting, lifecycle & denials
Illustrative interface
CLM‑DEMO‑0088 · posted from 835
billed / allowed / paid
Paid
CLM‑DEMO‑0089 · posted from 835
patient responsibility applied
Partial
CLM‑DEMO‑0090 · denial classified
CARC 197
Denied
CLM‑DEMO‑0091 · routed
RARC N…
Appealable
- A real 835 parser reads the ANSI X12 835 (005010X221A1) your payer or clearinghouse returns — payer, check/EFT, and per-claim paid, patient-responsibility and adjustment reason codes
- Automatic posting matches each remittance line to your claim, posts the payment and updates the status
- A scheduled job watches an inbox folder or clearinghouse endpoint and posts remittances hands-free, archiving each file
- Every denial is classified by its real CARC/RARC code into a work category, with an appealability call and a concrete next action
- Prior-authorisation tracking prevents auth-related denials (CARC 197/198) up front
Closed loop: qualified ledger → scrubbed 837P → submitted → 835 posted → paid or denied → denial to appeals. One system, fully auditable. Claim identifiers and codes shown here are synthetic examples.
Interoperability
Designed to work with the healthcare ecosystem.
Care360 is built to exchange data with the systems a practice already runs — and every schema assumption is declared in one place and confirmed against the live database, so integrations are explicit and auditable rather than hidden.
- FHIR R4 façadeExposes Care360 data — patients, conditions, vitals and observations — as FHIR R4 resources.
- EHR-agnostic adaptersA generic FHIR + SMART-on-FHIR client plus vendor adapters, to connect to any conformant EHR or aggregator.
- EHR write-backPushes vitals, care plan and notes back to the EHR as FHIR.
- ClearinghousePluggable claim submission and 835/ERA retrieval.
- Integration healthEvery schema assumption declared in one place and confirmed against the live database.
Referenced connectivity technologies. The platform overview describes adapters and connectivity involving the following services. They are listed here as supported integration technologies only.
athenahealth
Redox
Health Gorilla
Availity
Change / Optum
Claim.MD
No partner logos are displayed, and no partnership, endorsement or certification is implied.
Mobile Experience
Care360 on a smaller screen.
Care360 capabilities that translate naturally to a mobile context — the readings, the alerts, the tasks, the plain-language summary and the self-service requests that a person needs to see between visits.
Patient engagement
Vital readings
Alerts
Care tasks
AI summaries
Patient self-service
Appointment requests
Care-plan information
Scope note. This section is a visual presentation of platform capabilities on a mobile
layout. The Care360 Platform Overview does not specify a mobile application feature set, so no
mobile-specific functionality, native application, or app-store availability is claimed here.
Screens shown are illustrative compositions with synthetic values.
Value by stakeholder
Built for everyone who touches the work.
Select an audience to see what Care360 changes for them.
Providers & care teams
Prioritised, pre-drafted worklists.
A passive monitoring list becomes a prioritised worklist. The patients who need attention first surface first — with the action already drafted and the evidence attached.
- See what matters, first. Real-time vitals and alerts ranked by validated clinical risk instead of arriving as a feed.
- NEWS2 at a glance. Early-warning scores, escalating trends and AI clinical summaries on the row the nurse already works.
- Less searching, more caring. The evidence layer shows the specific readings behind every flag, so the team acts with context.
Practices & ACOs
The levers behind value-based performance.
Support AWV completion, earlier deterioration outreach, HCC risk capture and clean claims — in one platform, from one data spine.
- Fewer missed AWVs. Care-gap lists for visits due or never done, with an agentic scheduling proposal behind them.
- Captured HCC risk. Suspecting surfaces likely-but-uncoded conditions and quantifies RAF uplift with the official coefficient set.
- Cleaner claims. Deterministic scrubbing before submission, with the specific fix for each issue.
Payers
Results that hold up in review.
Deterministic, auditable risk and readmission models, plus clean, structured claims and denials — results that survive utilisation review.
- Reproducible models. Published clinical logic — the same inputs always produce the same score.
- Structured submission. ANSI X12 837P claims generated from a real qualified ledger, not a re-typed summary.
- Structured denials. CARC/RARC classification with an appealability call and a next action per denial.
Health systems & compliance
Easier to procure, deploy and defend.
Interoperability, governed AI and a closed-loop revenue cycle that plugs into existing clearinghouses and EHRs.
- Interoperable. FHIR R4 and SMART-on-FHIR with EHR-agnostic adapters and write-back.
- Governable AI. Fail-closed access control, PHI redaction at the AI boundary, BAA-aware routing and metadata-only egress logging.
- Auditable end to end. Every score shows its readings; every claim traces to the real ledger.
Why Care360
Reproducible, explainable intelligence on your own real data.
Vital Wave Technologies builds intelligent healthcare infrastructure: the layer that connects clinical monitoring, AI-assisted care management, predictive risk, population health, interoperability and revenue-cycle operations into one operating model.
01
Real data
Every score, claim and recommendation traces to real patient data. Nothing is fabricated, and nothing is estimated where it can be computed.
02
Explainable
Predictive scores show the signals behind them — every vital, its value, its date and its contribution.
03
Human-governed AI
AI assists; clinicians remain in control. The agent proposes, a person approves, and the platform records who and when.
04
Closed loop
Clinical activity connects to claims, payments and denials — from the first device reading to the reimbursed claim.
Real clinical data
Deterministic intelligence
AI assistance
Human oversight
Connected revenue cycle
Care360 does not ask healthcare organisations to choose between AI and clinical rigour. AI assists. A clinician decides. Every number is defensible.
Technology & architecture
An architecture your IT team can read.
Additive, isolated modules on a shared design system — every feature grounded in real data, with graceful fallbacks.
Application
Laravel 8 / PHP 8.2
Database
Microsoft SQL Server
AI
Google Gemini + deterministic clinical models
- grounded, fail-safe generation
- NEWS2 · readmission composite
Clinical / revenue standards
Standards-based, end to end
- FHIR R4
- SMART-on-FHIR
- ANSI X12 837P (005010X222A1)
- ANSI X12 835 (005010X221A1)
- CMS-1500
- CMS-HCC
- CARC / RARC
Documents
Server-rendered PDF
- CMS-1500 · 837P · reporting
Design
Additive, isolated modules
- shared design system
- graceful fallbacks throughout
Trust
Security, privacy & AI governance
Security and AI governance are built into the platform architecture.
Fail-closed RBAC
Access control denies by default. A user without the required feature privilege cannot reach a page or endpoint, with graceful handling of expired sessions.
PHI redaction at the AI boundary
Direct identifiers can be scrubbed from any prompt before it reaches an external model, and restored in the reply — defence in depth for the AI layer.
BAA-enforced AI routing
AI egress can be gated so PHI is only processed by a vendor with a signed Business Associate Agreement; otherwise the feature falls back to deterministic output.
Metadata-only AI egress logging
AI calls can be logged with provider, model and byte counts — evidence of what left the platform, without the log becoming a PHI store.
Evaluation harness
Golden-case tests prove the safety-critical pieces — PHI redaction and NEWS2 determinism — behave, and run in CI before release.
Deterministic clinical model behaviour
The same inputs always produce the same score, and implausible vitals are dropped rather than scored.
What this page does not claim. No regulatory certification or approval is asserted here. Vital Wave Technologies does not represent on this website that Care360 is HIPAA certified, SOC 2 certified, HITRUST certified, ISO certified or FDA approved. Any certification or attestation status will be published only when formally obtained and supplied by the company.
Clinical disclaimer. Care360 is a clinical support and care-management platform. AI-generated content and predictive outputs are intended to assist qualified healthcare professionals and do not replace professional clinical judgment, diagnosis, or treatment decisions.
Get started
Make every signal actionable.
See how Care360 connects monitoring, clinical intelligence, care automation and revenue cycle in one platform.
Or reach us directly — info@thevitalwave.com +1 516 888 9861