CareCompass — How It Works
A mobile‑first, HIPAA‑ready navigation layer that gets your members to the right care faster — with lower administrative load and measurable in‑network steerage.
Mobile‑first flow that turns a member’s plain‑language question into the next best action — find care, book, message, or resolve a bill.
Search in‑network providers, surface availability, and route to self‑serve booking or appropriate triage in seconds.
Translate coverage, estimates, and EOBs into clear English; reduce confused calls and abandoned care.
Track time‑to‑book, conversion, in‑network steerage, and CSAT; export to your BI tools.
Flow at a glance
Define cohort (1–3 clinics or member segment), confirm KPIs, finalize security scope.
Set up navigation rules, provider sources, and content. No EHR integration required for pilot.
Roll out to the pilot cohort with comms kit. Monitor conversion, time‑to‑book, and support deflection in real time.
Review analytics, iterate content, and plan EHR/FHIR integration where needed. Prepare ROI summary and next phase.
Employers & Providers
Reduce friction for patients, lighten admin load for staff, and measure impact in weeks — not quarters.
- Natural‑language entry ("I need a pediatrician near me Friday").
- In‑network search with availability cues.
- Direct booking where supported; smart hand‑offs elsewhere.
- Reminders, directions, and prep instructions keep patients on track.
- Simplified benefits and cost expectations before care.
- Translate EOBs into plain English with next steps.
- Route to the right channel automatically (benefits, billing, or provider).
Built for Payers
Increase benefit comprehension, steer members in‑network, and reduce avoidable utilization — while improving CAHPS/Stars drivers like access and customer service.
- Turn plan details (deductibles, copays, coinsurance) into actionable guidance before care.
- Estimate out‑of‑pocket ranges and surface lower‑cost, in‑network alternatives when available.
- Translate EOBs and denials into next steps (appeal, resubmit, talk to benefits).
- Directory search constrained to in‑network providers.
- Smart prompts to urgent care/telehealth over avoidable ER where clinically appropriate.
- Flags referrals needing authorization and routes members to the right workflow.
Reference Architecture
| Area | Primary Tech | Notes |
|---|---|---|
| Auth | AWS Cognito | Multi‑tenant support |
| App | Web (Next.js) + iOS/Android (Expo) | Brandable, multi‑tenant |
| API | Next.js API routes or AppSync + Lambda | Least‑privilege, auditable |
| Data | DynamoDB | Encrypted (KMS), PHI‑minimized |
| Files | Amazon S3 (optional) | At‑rest encryption, VPC endpoints |
| LLM | Self‑hosted or private gateway to approved models | No PHI persistence by default |
| Observability | CloudWatch + audit logs | Access trails & anomaly alerts |
Pilot Program (8–12 weeks)
Define cohort (1–3 clinics or member segment), confirm KPIs, finalize security scope.
Set up navigation rules, provider sources, and content. No EHR integration required for pilot.
Roll out to the pilot cohort with comms kit. Monitor conversion, time‑to‑book, and support deflection in real time.
Review analytics, iterate content, and plan EHR/FHIR integration where needed. Prepare ROI summary and next phase.
Enterprise FAQs
Ready to see CareCompass with your data?
We’ll stand up a pilot for a defined cohort and deliver a measurable ROI readout in 8–12 weeks.