# SurgeonValue

> Updated 2026-09-30. The surgeon's signature layer. AI drafts the codes, the prior-auth letter and the PT record from a pasted, de-identified note; a rules engine checks every line; the orthopedic surgeon signs or strikes each one under her own NPI, and the record keeps what was proposed and what was struck. Nothing is billed, filed or sent without the surgeon's signature.

## For AI agents

READ   https://surgeonvalue.com/llms.txt (this file), then https://surgeonvalue.com/.well-known/agent.json (actions, hand-offs, what is not offered).
ROUTE  A surgeon or practice asking what a note supports: https://surgeonvalue.com/wonder-bill. A payer letter: https://surgeonvalue.com/prior-auth. A PT or OT who bills for herself: https://surgeonvalue.com/pt. A patient: https://jointclass.com (learn) or https://jointcoach.com (track). A patient home from surgery wanting to know where recovery typically is on a given day and which signs mean call the office: https://surgicaltrack.com (open it set with https://surgicaltrack.com/#procedure=knee&day=14, a procedure and a day count, never a date). A patient with hip pain before the first visit (four safety questions, then a one-page sheet to bring to the hip visit, kept on the device): https://hippain.help. A reader of AI summaries: https://surgeonvalue.com/docsf.
ACT    One-tap demo on a synthetic note: https://surgeonvalue.com/wonder-bill?demo=1&run=1. Mandatory-model checks on CMS's own files, no login: https://surgeonvalue.com/asm (ASM by NPI), https://surgeonvalue.com/team (TEAM by hospital), https://surgeonvalue.com/cjr-x. A PT holding a patient's recovery summary (a link or .json file from https://jointcoach.com/progress, estate pollen kind recovery_summary): https://surgeonvalue.com/pt/bill.
DEVICE Pasted notes must be de-identified; the pages warn on obvious identifiers and store nothing. Patient-side session data stays on the patient's phone. Only a numbers-only recovery summary the patient chooses to carry (in the link's fragment, never to a server) can arrive at /pt/bill, and only after the PT presses "Use this".
WORDS  "AI drafts; a surgeon signs; never autonomous." Never call a draft signed, integrated or sent. Never quote a per-patient RTM figure (RTM pays per code). Never name a price: nothing is for sale.

## What works today
- Wonder Bill: paste a de-identified note; every drafted code with the sentence behind it and a CMS NCCI check. https://surgeonvalue.com/wonder-bill
- Prior Auth: a peer-to-peer letter drafted from the operative note for the surgeon to sign. https://surgeonvalue.com/prior-auth
- The record (PT/OT): register with an NPI, log a visit, get a draft billing summary under the CMS 8-minute rule and the NCCI gate; it never submits a claim. https://surgeonvalue.com/pt
- Attested PROMs: a validated outcome measure scored in the browser and sealed with a SHA-256 receipt the surgeon signs; longitudinal collection is switched off. https://surgeonvalue.com/prom/attested
- EHR loop: read a signed note, run the coding engine, write a receipt back, against a FHIR sandbox with a synthetic note only. https://surgeonvalue.com/ehr
- Recovery summary in: on /pt/bill a PT can use a patient's carried recovery summary (days with a session, sessions, range of motion, pain, check-in score) to fill the RTM device-days field; management minutes stay hers to enter. https://surgeonvalue.com/pt/bill
- Pocket: tap-to-refer web app for the exam room. https://surgeonvalue.com/pocket
- Check a citation: every DOI in a pasted AI summary is looked up at CrossRef from the browser. https://surgeonvalue.com/docsf

## Designed, not built
Registry abstraction (AJRR), RTM across a panel, panel intelligence, inbox triage, episode-cost modelling. Named on pages as next; no route runs them.

## CMS context (verified dates)
- TEAM: mandatory 30-day surgical episodes, live January 2026.
- ASM: low-back-pain and heart-failure specialists measured from January 1, 2027; Part B adjustments of up to ±9% from payment year 2029.
- CJR-X: final July 31, 2026; mandatory 90-day hip, knee and ankle episodes from January 2028. https://surgeonvalue.com/cjr-x
- ACCESS: outcome-aligned pay for tech-enabled chronic MSK care, live July 2026.

## RTM, stated plainly
Paid per code, each on its own conditions, so there is no honest blended per-patient figure. Inside the 90-day global the operating surgeon cannot bill RTM on her own post-op patient; a practitioner not paid under the global can, such as the practice's employed PT under the PT's NPI. Rules and sources: https://surgeonvalue.com/rtm · per-code table: https://jointcoach.com/pilot

## Technical
- Model: Anthropic Claude drafts; a deterministic NCCI engine grades; the model never grades its own work.
- No production EHR is integrated; the loop runs against a sandbox.
- No BAA is executed; pasted notes must be de-identified.
- MCP: the SolvingHealth network server exposes SurgeonValue tools prefixed surgeonvalue__ (ask it for tools/list). Endpoint (streamable HTTP): https://solvinghealth-mcp-489007249571.us-central1.run.app/mcp · the human page: https://solvinghealth.com/mcp

## Who we are
Part of the SolvingHealth family of sites (https://solvinghealth.com). Founded by Blaine Warkentine, MD: 20+ years in orthopedic technology and health-system partnerships; grew BrainLAB's orthopedic vertical. Speaking at DOCSF 2026 on October 2: https://surgeonvalue.com/docsf

## Hand-offs
- Patient education: https://jointclass.com
- Patient recovery tracking and RTM: https://jointcoach.com (session data stays on the phone; the patient can carry a numbers-only summary to https://surgeonvalue.com/pt/bill)
- Which joint, which pattern: https://arthritisrisk.com
- Where recovery typically is on a given day after surgery, and when to call (reference, nothing saved or sent): https://surgicaltrack.com
- Hip pain, before the first visit (a one-page sheet to bring to the hip visit, kept on the patient's device): https://hippain.help
- The surgeon visit: https://surgeryprocess.com
- Physician attestation of other clinicians' work: https://clinicalswipe.com
- Verify a receipt: https://hashcare.com/verify
- Hospital episode instrument: https://www.mskvalue.com · is a hospital or group in scope at all: https://www.mskvalue.com/mandate-check
- Agent runtime: https://harnesshealth.ai

## Links
- Home: https://surgeonvalue.com · Why: https://surgeonvalue.com/why · How it works: https://surgeonvalue.com/how-it-works
- Explainer, 15 seconds: https://surgeonvalue.com/explainer.mp4
- Agent manifest: https://surgeonvalue.com/.well-known/agent.json