Signal Alpha UR

Physician-led clinical determination and defense.

A clinical review tool built by an RN with a utilization management background, to support CMS Two-Midnight determinations, peer-to-peer review prep, and documentation gap detection. Built and working today; we’re early and don’t have live customers yet.

What It Does

Three modules, one review

Working in sync to support medical necessity determinations and hospital reimbursement.

Point-of-entry and concurrent evaluation

Evaluates patient charts at ED arrival and throughout the stay, checking severity-of-illness and intensity-of-service against evidence-based medical necessity criteria.

  • Two-Midnight rule hour calculations
  • Inpatient vs. observation level-of-care recommendations
  • Direct EHR integration via SMART on FHIR

Illustrative example

Meets inpatient medical necessity criteria: IV antibiotics and continuous monitoring required for acute appendicitis with peritonitis, expected stay crosses two midnights.

Technical Architecture

Built to meet hospital IT security review

This infrastructure is specific to Signal Alpha UR, the product that actually handles PHI. Signal Rate Benchmark is a separate system that works from public data and doesn’t need it.

Postgres Row-Level Security

Database RLS enforces strict hospital tenant isolation at the database level. Immutable append-only audit logs satisfy HIPAA audit controls.

OIDC Single Sign-On

Connects directly to hospital Google Workspace and Microsoft Entra ID accounts, with pre-provisioning security checks and mandatory MFA.

Autonomous System Monitoring

Real-time error triage engine managing per-tenant rate limits, automated failover, and emergency incident quarantine protocols.

Curious whether this fits your team?

Signal Alpha UR is real, built, and functional — but we’re early-stage with no live customers yet. Talk through your current UR workflow with us and see if it’s a fit, no pressure either way.