DeskGate
BAA active · Vertex AI · 28 Sep 2026
How we execute · Operator Extension 2.6.8
Your EHR, revenue-cycle and PA/UM systems decide and orchestrate. Residual work still leaks into the browser: payer portals, attachments, status phone trees and appeal drafts. DeskGate stages that leftover work inside the coordinator's own browser session, then stops. Chart notes and member IDs are not written to DeskGate databases, and the coordinator remains the Submit gate.
0Autonomous submissions. Submit, File, Affirm and Send are refused by the extension.
2 readsA field is kept only when two independent screen reads agree.
SHA-256What the ledger keeps of the payer reference. No names, member IDs or chart text.
The pipeline
Existing systems decide. Where their APIs end, the work leaks into the coordinator's browser. The Operator Extension works in that session, stages what it can quote and stops before anything irreversible.
EHR, RCM and PA/UM engines hold the chart, apply necessity guidelines, check eligibility and route billing.
Already in placeWhere there is no API, the work lands on the coordinator: payer portals, attachment merges, status calls and appeal drafts.
The residual gapOperator Extension 2.6.8 opens in the Chrome or Edge side panel, beside the payer tab the coordinator already logged into.
It reads the screen, matches box labels to chart facts, types into empty boxes and writes [MISS] where the chart is silent. Then it stops.
The coordinator reviews every staged box, resolves each [MISS], attaches files and clicks Submit.
CoordinatorAfter Submit, the payer reference is hashed in the browser. The ledger keeps the SHA-256, never the reference.
Systems named on this page are examples of the platforms a desk already runs. They are not DeskGate partners or integrations, and DeskGate does not replace them.
Layer by layer
Steps 1 to 4 are the Operator Extension on the coordinator's own seat. They are not the tools behind this website, and none of those tools is installed on the desk.
Layer 0 · Already in placeCustomer systems and core platforms
They already handle chart records, medical-necessity guidelines, eligibility checks, billing routing and general orchestration. They do not finish the last-mile clicks and document transfers that have no direct clearinghouse API.
The residual gapWhere software reaches its API boundary
Regional payer portals without APIs, multi-PDF attachment merges, missing clinical evidence, phone-tree status checks and appeal resubmissions. Today this work falls on overloaded internal staff or goes offshore.
1 · SessionChrome / Edge side panel
The extension runs on the coordinator's own seat, in the payer tab that is already logged in. It does not unlock portals, bypass MFA or call the payer. There is no cloud scraper and no remote browser.
2 · ReadVertex AI · deskgate-production
READ CHART sends one screen frame to Gemini on Vertex AI in project deskgate-production, under the Google Cloud BAA executed 28 September 2026. Chart facts and letter facts are kept in separate stores in the side panel. A field is kept only when two reads agree. DeskGate writes no chart data to its databases.
3 · MatchLabels only · 15-second backup
/api/map-fields receives box labels and fact names, never patient values. Values are typed from side-panel memory and every box is read back. lanes.js is the backup if Vertex AI does not answer within 15 seconds. Typing goes to the frame that owns the box.
4 · Stagecontent.js · never clicks
STAGE APPEAL quotes the chart or writes [MISS]. STAGE PORTAL types into empty boxes. Upload boxes are named, never filled. Submit, File, Affirm and Send are refused.
The human gateAutonomous submissions stay at zero
Routine keystrokes, document lookups and form staging are prepared for the coordinator. Submit buttons, appeal filings, prescription verifications and every other irreversible click wait for the coordinator. Nothing is filed without a person.
Ledger · SHA-256 in the browserCase record
At GATE, the extension hashes the payer reference in the browser and posts the desk, host, flags and that hash. No names, member IDs, chart text or raw reference. The desk product does not produce a PDF of the case.
Responsibility
Four parties touch a case. Only one of them files it.
Already there
Side panel only
v2.6.8
Files the case
Illustrative arithmetic
Move the sliders to see how the arithmetic responds. This is a model with stated assumptions, not a forecast and not a measured result. The 30-day ledger is the measurement.
Illustrative · not a forecast
No measured hour or percent figure appears here. Every number below follows from the inputs you set.
6.8
Modeled cases per coordinator-day (illustrative)
176 vs 245
Coordinator-days a month to clear the same queue, modeled vs today (illustrative)
Stated assumption. Modeled rate = today's rate × (1 + accept rate × 0.55), where 0.55 is the assumed share of a case's effort that is staging. Review at the gate is a new task and is never counted as saved, so the uplift stays well below the accept rate.
This is a model, not a result. DeskGate has no completed measurement, and no figure here comes from a live desk. The model shows how throughput responds to the gate-accept rate under the assumption above, so a desk can judge whether the mechanism is worth measuring at all. No dollar figure is shown on purpose: savings depend on a wage we do not know, and a vendor quoting your labor cost back to you is not evidence. The specimen ledger shows what the real report contains.
DeskGate does not replace your billing platform, your EHR or your clinical decision engine.
It works underneath existing systems on the residual work that still needs staff to copy between windows and work legacy payer portals by hand. Our working estimate puts that residual at 15–30% of volume on mixed-payer worklists. It is an estimate, not a measurement, and it varies by desk; the 30-day ledger is how a desk finds its own number.
Provenance. The ledger row carries the desk, host, flags and a SHA-256 of the payer reference. Chart facts stay in side-panel memory until NEW CASE or a different patient. Screen reads go to Vertex AI under the Google Cloud BAA, whose terms govern Google's side (Master Terms §4).
Operator runtime
Operator Extension 2.6.8 runs on Chrome and Edge. It opens in the side panel beside the payer tab the coordinator already logged into. Because it executes client-side, zero code changes or API integrations are required on Availity, CoverMyMeds, or any payer portal. Screen reads go to Vertex AI in project deskgate-production.
# Enterprise policy force-install (Google Admin / Intune):
bdhbnbpkkcageebgfabcecolflgembfe;https://deskgate.app/ext/updates.xml
# Pilot & developer workstation: Load unpacked from the public repository
# https://github.com/deskgate-app/deskgate-operator-2.6.8-public
# chrome://extensions → Developer mode → Load unpacked
# 1. The side panel opens beside the coordinator's authenticated session
# 2. It quotes on-screen chart facts and marks gaps [MISS]; it never clicks Submit
# 3. The coordinator reviews, attaches files, and clicks Submit
# 4. After Submit, a ledger row with a SHA-256 of the payer reference is writtenClient runtime: deskgate-operator-2.6.8-public (MIT). Extension ID: bdhbnbpkkcageebgfabcecolflgembfe. For internal practice dashboards, the client-side overlay is also accessible via /embed.js.
Next
The walkthrough shows the staging on synthetic cases. Access describes the free 30-day measurement for the first 10 desks.