Pryqelva AI is the enterprise AI operations platform built specifically for Medicare-certified home health agencies. It coordinates referral intake, clinical assessment documentation, constraint-based route dispatch, compliant care delivery, PDGM claims processing, and HHVBP quality surveillance into one continuous operating system — ensuring every clinical handoff is verified, on time, and audit-ready.
Built for Medicare-certified home health agencies
the central dashboardclinical operations command center
TheLiveCommandCenterForAgency-WideControl.
The Pryqelva AI Command Center is the centralized operational cockpit for home health agency leadership. Rather than toggling between disconnected EHR, scheduling, and clearinghouse tools, administrators oversee active patient episodes, field clinician coverage, regulatory submission timelines, and reimbursement risks in real time from one unified console.
app.pryqelva.ai/dashboard
Pryqelva AI — Clinical Operations Command Center dashboard
1
Patient Intake & Admission Ingestion
Real-time referral packet OCR extraction and automated 48-hour start-of-care clock management across hospital discharge records and physician orders.
Regions:
4×
faster referral intake
from 35-page hospital packets to confirmed admission readiness
94%
clean claim first-pass rate
zero billing delays from missing orders or coding discrepancies
< 90s
OASIS-E2 audit speed
automated contradiction detection across all clinical M-items
99.2%
LUPA threshold protection
proactive visit tracking across every 30-day PDGM payment period
The Nestack healthcare suite
Built for every corner of modern healthcare.
Healthcare moves differently in every care setting, with unique clinical teams, patient journeys, documentation standards, and regulatory frameworks. Your intelligence platform should be purpose-built to work the way your care specialty operates.
Connected Clinical Workflows, Built for the Care Continuum.
Every critical phase of home health delivery operates on one interconnected platform. From referral qualification and OASIS-E2 validation to route scheduling, field care, billing, and quality oversight — each workflow operates autonomously while sharing continuous clinical context across your entire agency.
app.pryqelva.ai/patient-intake
Pryqelva AI — Patient Intake dashboard
Patient Intake01 / 07
Intelligent referral ingestion and admission qualification.
Patient Intake serves as the automated front door for home health admissions. It extracts diagnoses, skilled disciplines, and face-to-face physician orders from dense hospital discharge packets in seconds. By verifying insurance coverage and clinician territory capacity before acceptance, agencies maintain compliant 48-hour start-of-care readiness.
packet OCR extraction
F2F verification
48-hr SOC clock
payer eligibility
app.pryqelva.ai/patient-assessment
Pryqelva AI — Patient Assessment dashboard
Patient Assessment02 / 07
Clinical OASIS-E2 validation with instant consistency checks.
Patient Assessment is the comprehensive evaluation studio for admitting nurses and therapists. It guides clinicians through OASIS-E2 documentation while detecting contradictions between narrative notes and structured M-items in real time. Clinicians complete accurate medication reconciliation and avoid costly CMS submission rejections.
OASIS-E2 validation
narrative conflict check
medication reconciliation
PDGM grouping
app.pryqelva.ai/care-planning
Pryqelva AI — Care Planning dashboard
Care Planning03 / 07
Automated assessment-to-plan drafting under clinical control.
Care Planning translates clinical assessment findings into individualized, measurable plans of care. It synthesizes assessment data to establish patient goals, ordered discipline frequencies, and interventions aligned with physician directives. Supervisors easily review and finalize compliant CMS-485 certification documents ready for signature.
measurable goals
discipline frequency
CMS-485 orders
practitioner signature
app.pryqelva.ai/visit-scheduling
Pryqelva AI — Visit Scheduling dashboard
Visit Scheduling04 / 07
Constraint-optimized territory routing and clinician dispatch.
Visit Scheduling manages complex field logistics across every agency service area. It balances clinician discipline competencies, patient time preferences, ordered visit frequencies, and caregiver continuity while minimizing windshield drive times. Daily scheduling conflicts and call-outs are resolved in seconds without dropping ordered visits.
drive-time minimization
license matching
continuity scoring
EVV alignment
app.pryqelva.ai/care-delivery
Pryqelva AI — Care Delivery dashboard
Care Delivery05 / 07
Point-of-care field documentation with integrated EVV.
Care Delivery equips visiting nurses, therapists, and home health aides with a mobile bedside workspace. Clinicians capture structured encounter notes, vital signs, and wound progression directly in the patient home. Automated GPS and timestamp verification provide audit-proof Electronic Visit Verification (EVV) across Medicaid and Medicare visits.
voice-to-note charting
wound telemetry
EVV reconciliation
change-in-condition
app.pryqelva.ai/billing-claims
Pryqelva AI — Billing & Claims dashboard
Billing & Claims06 / 07
Proactive PDGM LUPA protection and 5-day NOA tracking.
Billing & Claims replaces retroactive denial chasing with proactive payment period oversight. The platform continuously monitors the mandatory 5-day Notice of Admission (NOA) filing clock, projects visit pacing against PDGM LUPA thresholds, and audits unsigned physician orders before final submission to ensure clean, first-pass 837I claims.
5-day NOA clock
LUPA headroom forecast
unsigned order aging
clean 837I claims
app.pryqelva.ai/quality-compliance
Pryqelva AI — Quality & Compliance dashboard
Quality & Compliance07 / 07
Predictive hospitalization risk and HHVBP quality surveillance.
Quality & Compliance provides continuous clinical surveillance and regulatory oversight. It analyzes patient vital trends and functional scores to detect 30-day hospitalization risks before emergency events occur. By tracking the CMS 90% OASIS quality threshold and modeling Expanded HHVBP scores, it safeguards agency reputation and reimbursement.
Home health care moves across complex regulatory clocks — 48-hour start-of-care deadlines, OASIS-E2 consistency, field route dispatch, and 30-day PDGM payment periods.Pryqelva AI unites every step into an integrated clinical operations system, keeping every handoff verified while clinicians remain in total command.
step one
Referral Ingestion & Admission Qualification
When a hospital referral arrives, dense discharge packets, physician orders, and face-to-face documentation are ingested into the platform. The system extracts qualifying skilled needs and homebound evidence in seconds, verifies payer coverage, and cross-references clinician territory availability to ensure safe, on-time admission within the mandatory 48-hour regulatory clock.
01
step two
OASIS-E2 Clinical Assessment & Care Plan Generation
Field RNs and therapists conduct comprehensive in-home evaluations guided by real-time consistency checks. The system cross-references narrative notes against structured M-items, performs medication reconciliation, and drafts individualized care plans with measurable goals, ordered visit frequencies, and CMS-485 certification packets ready for physician signature.
02
step three
Route Dispatch, Field Care Delivery & PDGM Claims
Schedulers dispatch clinical visits using constraint optimization that minimizes windshield drive time while maintaining caregiver continuity. In-home visits capture bedside documentation with GPS-verified EVV, flowing directly into proactive PDGM LUPA tracking, 5-day Notice of Admission filings, and first-pass clean 837I claim submissions.
03
The work stays where it belongs — with the person your team is caring for, not the paperwork that surrounds them.
Traditional SaaS vs Pryqelva AI
Don’t settle for the AI your software chose.
Most legacy home health platforms lock you into generic or manual workflows.Pryqelva AI puts an intelligent clinical orchestration layer between incoming medical records and modern AI, ensuring every stage of a patient episode runs on task-specific models.
Traditional SaaS
Built-in AI
One model, one pass, and no step you can point somewhere else.
You work within its limits.
Pryqelva AI · Routed care flow
01
Ingest multi-page referral packets
Layout-aware vision OCR parses dense hospital transfer summaries, handwritten orders, and F2F forms that general LLMs scramble.
MMistralDocument AI / OCR
02
Extract homebound & skilled need evidence
A fine-tuned medical classifier isolates physical mobility deficits and skilled nursing requirements with source document citations.
HFHugging FaceInference Providers
03
Synthesize clinical episode & medications
Long-context reasoning analyzes multi-year EHR histories and discharge medication lists to flag drug duplications and interactions.
GGeminiGemini API
04
Structure into OASIS-E2 & FHIR R4
Constrained decoding maps assessment findings directly into standard CMS OASIS-E2 data specifications and FHIR records.
AIOpenAIStructured Outputs API
05
Draft the individualized plan of care
Generates discipline frequencies, measurable therapy goals, and CMS-485 orders traceable to underlying assessment findings.
AClaudeAnthropic Messages API
06
Check narrative vs. M-item consistency
Dual-pass scoring compares clinician visit narratives against structured functional items to prevent CMS audit contradictions.
DSDeepSeekDeepSeek API
07
Classify PDGM case-mix & LUPA thresholds
Maps clinical groupings, functional impairment, and comorbidities across all 432 PDGM payment cells to forecast revenue risks.
CCohereRerank + Rules Engine
08
Redact ePHI inside your private VPC
A dedicated on-premise model de-identifies HIPAA-regulated patient identifiers before any external API processing occurs.
LLlamaSelf-hosted in your VPC
One structured clinical file184 fields · 98.4% mean confidence · 0 held for review
Note: Model and product names are trademarks of their respective owners, used here to describe what runs where. Routing is configurable per workflow — no endorsement or partnership is implied.
Compliance
Built to the rules you are already held to
Skilled home health care runs on clinical and billing records that have to be exactly right. Pryqelva AI is designed around the federal and clinical regimes below — here is what it supports, and what each one actually covers.
42 CFR Part 484
CMS Conditions of Participation — 42 CFR Part 484
Tracks key operational requirements including assessment timing, plan-of-care review cycles, supervisory requirements and QAPI evidence, with configurable reminders and compliance exceptions.
Supported Workflows
Patient Intake, Patient Assessment, Care Planning, Care Delivery, Quality & Compliance
OASIS-E2 & PDGM
OASIS-E2 & PDGM Readiness
Checks OASIS-E2 assessments for completeness, consistency and submission-rule exceptions, supports PDGM case-mix classification, and monitors applicable 30-day payment-period and LUPA risks.
Supported Workflows
Patient Assessment, Care Planning, Billing & Claims, Quality & Compliance
Reconciles scheduled visits with available EVV arrival/departure events, timestamps and clinical documentation, and flags missing or inconsistent verification for applicable Medicaid-funded home health visits.
Supported Workflows
Visit Scheduling, Care Delivery, Billing & Claims
HIPAA & HITECH
HIPAA & HITECH Privacy and Security Controls
Protects ePHI within Pryqelva through role-based access, audit logging, encryption and configurable security controls designed to support customers' HIPAA and HITECH compliance obligations.
Supported Workflows
All platform modules & cloud infrastructure
Note: These are standards the platform is built to support inside your workflows — obligations that fall on you as the licensee. They are not certifications held by us, and support in the product is not a substitute for your own counsel or compliance officer.
Add-ons
Add the hardware your workflow needs.
Clinical workflows often originate with physical paper, in-home biometric sensors, or bedside packaging. These third-party compatible enterprise peripherals integrate directly with Pryqelva AI—streaming verified data straight into the module that manages that clinical handoff.
Document Ingestion
High-Speed Duplex Network Document Scanner
Enterprise desktop sheet-fed scanner built for high-volume intake desks. Digitize dense 35+ page hospital discharge summaries, signed face-to-face physician orders, laboratory panels, and insurance cards in a single duplex pass. Scans stream straight to the extraction pipeline for automated OCR, skilled-need qualification, and immediate start-of-care clock tracking.
IntegrationDirect-to-Cloud REST API / TWAIN-over-IP
FeedsPatient Intake & Admission Readiness
IoT & Biometrics
Cellular & BLE Remote Patient Telemetry Gateway
Medical-grade home gateway operating over dedicated multi-carrier cellular, requiring no patient Wi-Fi configuration. Pairs automatically over Bluetooth with certified blood pressure cuffs, pulse oximeters, weight scales, and glucometers. Streams biometric trends into the active visit record and triggers automatic RN Case Manager alerts when readings breach clinical thresholds.
Standardized optical calibration target and companion field sensor probe designed for visiting skilled nurses. Compensates for variable residential ambient lighting, measuring exact wound perimeter, surface area (cm²), and depth while classifying tissue composition (granulation vs. slough) to substantiate medical necessity and track longitudinal healing.
Healthcare-grade, disinfectant-ready wireless 2D scanner designed for field nursing kits. Rapidly decodes curved prescription vial labels, unit-dose blister packaging, and surgical supply GS1 DataMatrix codes at the bedside—verifying National Drug Codes (NDCs) against the active medication profile and tracking billable DME wound care supplies.
Note: Hardware, installation, and integration are not included in the standard subscription. Additional charges apply based on the hardware selected, integration modules required, and implementation scope.
Connectivity
Your whole stack, connected.
Epic Systems, Cerner, PointClickCare, Athenahealth, Availity, Change Healthcare — and the rest of what your post-acute and skilled home health agency already runs on. 24 integrations across intake, clinical assessment, billing clearinghouses, and enterprise cloud APIs.
Epic SystemsOracle Health / CernerPointClickCareAthenahealthChange HealthcareSalesforce Health CloudVeeva VaultTwilio HIPAA SMSSendGridVonage TelehealthSlack Care HuddlesMicrosoft TeamsSnowflake Health DataEpic SystemsOracle Health / CernerPointClickCareAthenahealthChange HealthcareSalesforce Health CloudVeeva VaultTwilio HIPAA SMSSendGridVonage TelehealthSlack Care HuddlesMicrosoft TeamsSnowflake Health DataEpic SystemsOracle Health / CernerPointClickCareAthenahealthChange HealthcareSalesforce Health CloudVeeva VaultTwilio HIPAA SMSSendGridVonage TelehealthSlack Care HuddlesMicrosoft TeamsSnowflake Health Data
AWS HealthLakeGoogle BigQueryDatabricksJira SoftwareLinearHubSpot CRMAvaility ClearinghouseDocuSign Life SciencesAzure Health DataTableauPower BIZapierAWS HealthLakeGoogle BigQueryDatabricksJira SoftwareLinearHubSpot CRMAvaility ClearinghouseDocuSign Life SciencesAzure Health DataTableauPower BIZapierAWS HealthLakeGoogle BigQueryDatabricksJira SoftwareLinearHubSpot CRMAvaility ClearinghouseDocuSign Life SciencesAzure Health DataTableauPower BIZapier
Note: Tool names and marks belong to their respective owners. No endorsement or partnership implied.
our prices
Supportthatfitsyouragency.
A first conversation is often just that — a conversation. From there it is one plan at one price, whichever operational threads of home health care you hand to Pryqelva AI. No complex per-visit maths, no hidden tier multipliers.
the whole agency
$200/mo
Starting at $200/mo — every module, every clinician and branch, billed monthly.
Note: AI API usage is charged separately. Clients must recharge their AI credit balance based on their usage.
Nothing is locked in. Move at the pace your agency moves — change or pause whenever it suits you.
onboarding
What your onboarding fee covers
A one-time setup that gets your agency fully live before your first billing cycle — we import your patient census and clinician rosters, connect your EMR and clearinghouse APIs, configure OASIS-E2 validation rules, and calibrate PDGM and EVV workflows to the way your clinical field teams actually operate.
Each fee is a starting point marked with a “+”. We scope the final onboarding once we understand your environment, security needs, integrations, data volume, compliance requirements and deployment model — so you only pay for the work your agency actually needs.
Essential
$1,000+one-time
Kickoff call with your Director of Clinical Services (DCS) and clinical supervisors
Pryqelva workspace provisioned with your agency branding, branches, and admin accounts
Import of active patient census, clinician roster, and geographic service territories
Referral packet intake templates and F2F extraction workflows mapped
Roles and permissions set for DCS, case managers, field clinicians, schedulers, and billers
Electronic Visit Verification (EVV) state adapter configuration and testing
Live-readiness walkthrough and an agency onboarding handbook before your first billing cycle
Plus
most chosen
$2,500+one-time
Everything in Essential, plus:
Guided migration of active OASIS-E2 records, plans of care, and physician orders
Two integrations wired up — your Home Health EHR (HCHB, WellSky, Axxess) or clearinghouse (Availity)
Document extraction model calibrated on your hospital discharge referral formats
PDGM 30-day payment period tracking and LUPA threshold alert rules configured
Live training session for field nurses, therapists, and case managers, with a recording to keep
A dedicated home health onboarding specialist through go-live
Enterprise
$5,000+one-time
Everything in Plus, plus:
Multi-branch and regional agency rollout with custom organizational hierarchy
Enterprise SSO, signed HIPAA BAA, and custom ePHI data retention and audit policies
High-volume legacy records migration with deduplication and active episode reconciliation
Automated 5-day Notice of Admission (NOA) submission pipelines and claims scrubbing rules
Role-based training tracks for intake, clinical QA, scheduling, and billing departments
Dedicated implementation manager with guaranteed SLA and post-launch audit review
how it runs
Two ways to run Pryqelva AI — same platform, same subscription rate. Only the onboarding may differ by your requirements.
Cloud (SaaS)
Runs in Nestack's managed cloud — the fastest way to go live. We handle hosting, updates and scaling so your agency clinical teams log in and start working immediately.
Private / self-hosted
The same Pryqelva platform deployed inside your own infrastructure — your cloud, VPC or on-prem — for agencies handling protected health information (ePHI), OASIS-E2 submissions, and billing clearinghouse records. Your data never leaves your environment, and the subscription rate stays the same.
Sister platform — Nestack Agent Care
Your Home Health Services AI agents, run like production systems.
Telemetry, evaluations, guardrails, human review, and a crew on call when one of them starts drifting at 3am.
Pinned to the Home Health Services agent playbook — not a generic agent checklist.
common questions
Yourquestions.Answeredplainly.
Bringing software into a clinical operation built on patient care raises fair questions. These are the ones agency leaders, clinical directors, and administrators ask us first.
About Pryqelva AI
How is Pryqelva AI priced for home health agencies?
Pryqelva AI is designed for agencies of different sizes, from a single branch to multi-location home health organizations. Pricing can be structured around factors such as branch count, operational volume, number of users, and the modules you activate. Before you subscribe, we define the scope clearly so you know what is included and can evaluate the expected operational return before committing.
Do we have to replace our existing home health EMR or EHR to use Pryqelva AI?
No. Pryqelva AI is designed to work alongside your existing clinical and operational systems rather than forcing an immediate EMR replacement. The platform can support workflows around referral intake, OASIS review, scheduling, care delivery, billing readiness, and quality operations while integrating with the systems your teams already depend on.
How quickly can our agency start using Pryqelva AI?
Implementation depends on the number of branches, integrations, payer workflows, and modules being activated. A focused rollout can begin with a high-friction workflow such as Patient Intake or Visit Scheduling, then expand into Patient Assessment, Care Planning, Care Delivery, Billing & Claims, and Quality & Compliance. This reduces disruption and allows your team to prove value before a wider rollout.
What measurable value should we expect from the platform?
Pryqelva AI is built to reduce the operational delays that affect home health agencies every day: incomplete referral packets, delayed SOC readiness, uncovered visits, late documentation, unsigned orders, EVV exceptions, claim blockers, and quality follow-up gaps. Buyers should evaluate the platform against measurable outcomes such as referral-to-SOC time, visit fill rate, documentation turnaround, claim readiness, administrative workload, and exception resolution time.
How does Pryqelva AI protect patient information and support HIPAA requirements?
Pryqelva AI is designed for healthcare workflows involving protected health information. The platform can support controls such as role-based access, encryption, audit logging, secure authentication, permission management, and traceable user activity. These controls are designed to support your agency's HIPAA and HITECH obligations, while your own policies, workforce procedures, and compliance program remain part of your overall responsibility.
What happens if the AI makes an incorrect recommendation?
Pryqelva AI is designed as an operational and clinical workflow assistant, not a replacement for licensed clinical judgment. AI-generated assessments, care-plan suggestions, documentation findings, risk alerts, and compliance checks remain reviewable by authorized users. The platform should show the supporting evidence behind important recommendations so your staff can verify the information before acting on it.
What support do we receive after subscribing?
Your team should receive implementation support, workflow configuration, administrator onboarding, user training, and ongoing product assistance. For larger or multi-branch organizations, rollout support can be structured by branch or workflow so intake, clinical, scheduling, billing, and quality teams are not forced to change everything at once. Ongoing support should also cover configuration changes, integrations, user access, and operational troubleshooting.
Didn’t find your answer? Send us a message — we’ll respond with care and clarity.
