Synthetic data prototype — no PHI. Numbers, names, and IDs are fabricated for design review only.

Patient 360

Longitudinal Episode View

Search a synthetic patient or episode to inspect discharge → TCM → PCM → billing → outcomes end-to-end.

Helen Reyes

PT-000017 · USC-900017 · EPI-2026-0017

PCM ActiveMedium riskCommercialProstate Cancer

Specialist Post-SurgicalPost-Surgical SPOCManual ReferralAI 72%Prostate Cancer RecoveryLongitudinalTCMPCMPost-Acute

NBA: Continue care plan; no urgent action

Reason codes: HIGH_LOS, RECENT_FALL

Outreach

PCM Min.

Paid $

$235

Age / Sex

64 · F

ZIP

90001

Language

English

Payer

United Healthcare

Procedure

Robotic Prostatectomy

Surgeon

Dr. Priya Ramaswamy

Surgery Site

Keck Hospital of USC

Surgery Date

Feb 08, 2026

Discharge

Feb 11, 2026

LOS

Status

PCM Active

Consent

On file

Episode Timeline

22 events

Program Assignment · PCM · Ineligible - Coverage

2026-02-02 00:00

Not accepted (Fail payer check)

Intake Trigger · Manual Referral · Manual entry by Ops Coordinator

2026-02-02 12:45

Routed at 2026-02-02 00:00

AI Detection · AI score 72%

2026-02-02 12:45

HIGH_LOS, RECENT_FALL

Program Assignment · TCM · Eligible

2026-02-03 00:00

Accepted (assigned by AI Engine)

Program Assignment · Post-Acute · Eligible

2026-02-03 00:00

Accepted (assigned by AI Engine)

Surgery · Robotic Prostatectomy

2026-02-08

Dr. Priya Ramaswamy

Discharge · LOS 3d

2026-02-11

Outreach · Attempt 2 · TCM Accepted

2026-02-12 17:15

Felix Stone

Outreach · Attempt 1 · No Answer

2026-02-13 15:30

Liam Chen

Steerage · Follow-up → External

2026-02-16

Pacific Imaging (External)

TCM Encounter · Telehealth · CPT 99495

2026-02-20

Note sent to USC

Billing · TCM Encounter · CPT 99495 · Paid

2026-02-20

$168 / $168

PCM Enrollment · Enrolled · consent signed

2026-02-25

PCM Activity · Med Reconciliation · 12m

2026-02-27 17:40

Elena Rivera

Utilization · Readmission · Hematuria

2026-03-03 22:57

In-network

Exception · Referral Leakage Risk · Medium · In Progress

2026-03-07 11:00

Carmen Ortiz

Satisfaction · Post-TCM · 4.4/5

2026-03-09

PCM Activity · Specialist Coordination · 16m

2026-04-05 15:50

Naomi Reyes

Billing · PCM Monthly · CPT 99426 · Paid

2026-04-15

$67 / $67

Billing · PCM Monthly · CPT 99426 · Pending

2026-04-15

$0 / $73

PCM Activity · Symptom Check · 11m

2026-04-16 15:30

Naomi Reyes

PCM Activity · Specialist Coordination · 9m

2026-04-21 09:10

Naomi Reyes

Outreach Attempts

ID	Attempt	Datetime	Outcome	Staff	Min
OUT-0038	#1	2026-02-13 15:30	No Answer	Liam Chen	4
OUT-0039	#2	2026-02-12 17:15	TCM Accepted	Felix Stone	8

TCM Encounters

ID	Encounter	Type	CPT	Doc Complete	Note → USC	Staff
TCM-0013	2026-02-20	Telehealth	99495	Yes	Yes	Jamal Carter

1 satisfaction survey(s) on file — see timeline.

Actionable Chat

Synthetic

I can answer questions about this patient's EPIC workflow, intake trigger, pathway, programs, order set, tasks, and billing evidence. Try one of the suggested prompts below.

Next Best Actions

Rule-based recommendations derived from the patient's current state.

Review exception: Referral Leakage Risk
Low
Medium severity · 27d open
Owner: MA
Resolve eligibility for PCM
High
Ineligible - Coverage (payer check Fail)
Owner: Ops Coordinator
Backfill PCM Monthly Activity RWE
Low
PCM Monthly Activity only 38% complete
Owner: Ops Coordinator
Backfill Steerage History RWE
Low
Steerage History only 46% complete
Owner: Ops Coordinator

Open Exceptions

Referral Leakage Risk
27d open · In Progress
Medium

Longitudinal Episode View

Helen Reyes

Episode Timeline

Outreach Attempts

TCM Encounters

Actionable Chat

Chat QA Checklist

Next Best Actions

Open Exceptions