Care Access Trust Network
CATN
by EVRESA LLC  ·  Orlando, Florida
Human Authority, Enforced at Machine Speed.
The AI governance and proof layer hospitals need to comply with CMS-0057-F — and recover the millions in legitimate claims that have never been filed.
7%
of eligible NSA IDR claims filed in 2023
93%
of eligible claims never filed
85%
win rate with proper documentation
2.7×
median IDR award vs qualifying payment
Request a Pilot Introduction See How It Works →
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The Core Invariant
No AI ever auto-denies patient care.
Every AI denial recommendation is intercepted and routed as a HOLD. A credentialed physician — NPI-bound, cryptographically attested — makes the final call. Every time. Without exception. This is not a setting. It is an enforced architectural constraint.
HumanAuthorityReceipt CallEvidenceReceipt BNInferenceReceipt AIGRChainReceipt CertificationReceipt PilotReadyReceipt
What CATN Does
Three jobs no existing
prior auth tool does.
CATN is not a replacement for your prior auth workflow. It is the governance, evidence, and intelligence layer that sits on top of it — generating proof as a byproduct of the clinical process.
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Governance
Intercepts every AI denial recommendation before it executes. Routes as a HOLD. Requires NPI-bound physician attestation. Generates a tamper-evident, SHA-256 anchored receipt chain defensible in a CMS audit or NSA arbitration proceeding.
"Your AI decisions just became provably human."
HumanAuthorityReceipt AIGRChainReceipt
02 / 03
📞
Evidence
Every payer phone call is ingested, transcribed, HIPAA-redacted, summarized, and commitment-extracted. Payer verbal commitments become enforceable timers. The entire pipeline is anchored to the case record with a cryptographic receipt. Court-grade evidence, generated automatically.
"That call just became court-grade evidence. That's new."
CallEvidenceReceipt CommitmentReceipt
03 / 03
📊
Intelligence
Bayesian Network inference detects payer denial patterns across cases — not just individual decisions. When a payer's denial rate deviates +2.3 standard deviations from baseline on a specific DRG, the system escalates automatically with a pre-built evidence packet. Fight denials systematically, not case by case.
"Your payer patterns just became leverage."
BNInferenceReceipt PayerPatternReceipt
Platform in Action
Meet Dorothy Harrison.
Every CATN demo runs on a real clinical scenario. This is how a 79-year-old hip replacement patient — facing an AI denial from Humana — becomes the clearest explanation of why this infrastructure exists.
ENC-0039 HOLD — P5 CARE DELAY
Patient Dorothy Harrison, 79F
Procedure DRG 0302 — Hip Replacement
Payer Humana
AI Recommendation DENY — 83% confidence
CATN Verdict HOLD — Human Review Required
BN Finding Humana SNF: 6.2 days actual
vs 3–5 stated (+1.8 SD)
Attending Dr. Patricia Mendez — NPI Attested
7-Stage Call Evidence Pipeline
1

Ingest (CAI)

Audio anchored to case record with timestamp and case ID

2

Transcribe (CTR)

Full transcript with speaker diarization — who said what, when

3

Redact (CRD)

HIPAA-compliant PHI redaction before any further processing

4

Summarize (CSM)

Clinical summary of call outcomes and stated denial reasons

5

Extract Commitments (CCM)

"We'll have an answer by Thursday" becomes an enforceable timer

6

BN Inference (BNI)

Bayesian Network evaluates call outcomes against case evidence

7

Integrity Check (CIN)

SHA-256 anchored to AIGR chain — every record tamper-evident

"That call just became court-grade evidence. That's new."

Role-Based Design
Every role sees exactly
what they need.
CATN is not one interface. It is four purpose-built workspaces — each designed for the specific decisions and accountabilities of a distinct clinical role.
CMO / Chief Medical Officer
Governance proof for the AI your organization is already using.
  • CMS-0057-F compliance — tamper-evident audit trail on demand
  • NPI-bound physician attestation for every denial recommendation
  • AIGR chain: cryptographically anchored, court-defensible
  • AI governance proof that survives federal scrutiny
CNO / Chief Nursing Officer
One action chip. No complexity. No ambiguity.
  • Nurse sees exactly one action — what to do, direct line, call script
  • SLA enforcement removes the guesswork from escalation
  • Automatic escalation when payer timelines are breached
  • Staff cognitive load reduced — complexity lives in the infrastructure
CFO / Finance
The 93% of eligible claims that have never been filed.
  • $1.4M labor savings — prior auth touch time reduced 63%
  • $2.3M avoidable costs eliminated — discharge delay reduction
  • $740K denial recovery — 68% overturn rate with complete documentation
  • NSA IDR filing capability — 2.7× median award vs qualifying payment
UM Lead / Utilization Management
Stop fighting denials case by case. Fight them systematically.
  • Payer pattern intelligence — +2.3 SD triggers automatic P2P escalation
  • Every payer call commitment captured and enforced with a timer
  • Payer Playbook per DRG per payer — built from your own case history
  • NSA IDR packet generation — from 6-week reconstruction to document export
Central Florida
Five institutions.
One district. One platform.
Florida's 9th Congressional District contains a complete cross-section of American healthcare — from academic medicine to pediatric specialty to the largest Puerto Rican and Latino-serving community hospital in the United States. CATN is ready to deploy across all five.
AdventHealth Celebration
Adult Acute Care · Faith-Based Nonprofit
50+ care sites across Central Florida. Rob Purinton (CAIO, appointed January 2025) carries an explicit mandate to prove AI governance compliance under CMS-0057-F. The Celebration campus is the district's flagship innovation-focused health system.
Orlando Health
Community Health · Locally Owned
The largest locally owned health system in Central Florida. 10 hospitals, 30+ emergency departments, 3.5 million patient encounters annually. St. Cloud Hospital serves the district directly.
HCA Florida / UCF Lake Nona
Academic Medicine · Teaching Hospital
Florida's largest healthcare network. UCF Lake Nona Hospital is a $175M academic teaching hospital — 350+ jobs, $13.8M in annual charity care — located in Orlando's Medical City, directly in the district.
Nemours Children's Hospital
Pediatric Specialty · Nationally Recognized
Nationally recognized pediatric specialty care. Serves the district's highest-need pediatric population — including Medicaid-dependent and underinsured families. AI denial rates in pediatric specialty care are among the highest of any care category.
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HCA Florida Poinciana Hospital
Community Hospital · Osceola & Polk Counties · The Heart of the District
Poinciana is home to one of the largest Puerto Rican and Latino communities in the United States. HCA Florida Poinciana Hospital — a 94-bed acute care facility with a 31-bed emergency department — is the primary healthcare institution for this community. Prior authorization denials in Poinciana disproportionately affect Spanish-speaking, Medicaid-enrolled, and underinsured patients who lack the resources to challenge incorrect AI-recommended denials. CATN would bring the same governance infrastructure available to large urban systems directly to the community that needs it most.

Adult acute care. Community health. Academic medicine. Pediatric specialty. The largest Puerto Rican and Latino-serving community hospital in Central Florida. One congressional district. One governance platform built and ready to deploy.

Get Started
Request a Pilot
Introduction.
We are seeking pilot deployments with hospitals across Central Florida and welcome any introductions. A 30-day, 50-case pilot generates the first CMS-0057-F-compliant AI governance receipt chain in your environment.

✓ Request Received

Thank you. John or Gilbert will be in touch within 24 hours.
For urgent inquiries: 321-696-6766 or info@evresaai.com

info@evresaai.com 321-696-6766 evresaai.com