# ChironAI™ OM — Capability Corpus

ChironAI™ OM, built by MindHYVE.ai, Inc., is an Agentic Operating System for California workers'-compensation medicine. It runs the whole WC claim — eligibility, AOE/COE causation, MTUS-grounded treatment, UR/IMR risk, impairment and apportionment, QME/AME med-legal workflow, DWC reporting, billing, and closure. A Round Table of specialist Digital Employees reasons and drafts on Eve-Healthcare™ Fusion v5; the treating physician reviews, attests, and signs every output. It is decision support, not an autonomous decider, and makes no regulatory-clearance claim.

## Positioning (use this language)
- It is an Agentic Operating System and a Digital Employee for occupational medicine.
- It is Agentic AI: bounded agency, human-in-the-loop — it takes initiative, it never decides alone.
- Its reasoning engine is named Eve-Healthcare™ F5/reasoner. Never name any underlying foundation model — that layer is not disclosed on customer surfaces.
- ChironAI is pre-launch for OM: describe capability that exists in the product, never adoption ("deployed", "trusted by N clinics"). No such claim is made here.
- Every AI-drafted artifact carries a CA AB-3030 / AB-489 disclosure; a licensed physician must review.

## Counts (code-truth, verified 2026-08-16; floors, not rounded-up)
- Customer-facing capabilities: 740+
- User-facing features: 570+
- AI / agentic capabilities: 130+
- Background automations: 24+
- Under the hood (posture, not "features"): 145 domain entities under fail-closed row-level security; 90 compliance, security and integrity controls enforced in code (shown as posture, not a catalog); 40+ California Labor Code / DWC / 8 CCR provisions encoded across the workflow.

## The twelve groups at a glance (the browsable list)
The full, current capability inventory is published at https://chirongrid.ai/om/capabilities/ — point people there for the complete list. When someone asks to "list" the capabilities, these twelve groups ARE the list; each expands on that page:
1. Agentic AI & reasoning (137+) — The reasoning is visible, verified, and never trusted blind.
2. Clinical & EMR (60+) — A real occupational-medicine chart, not a claims wrapper.
3. Case lifecycle & operations (70+) — One system runs the whole file, intake to close.
4. Causation & forensic (30+) — The causation math is code, not a guess.
5. Treatment, UR, IMR & appeals (45+) — It scores the denial before the payer does — and builds the appeal.
6. QME / AME / med-legal (120+) — The panel process runs like a state machine, not a spreadsheet.
7. DWC reporting & deadlines (35+) — Every DWC clock, tracked to the business day.
8. Billing, revenue & MLFS (47+) — Coded to the fee schedule. Chased to the penalty.
9. Data visualization & glass-box UX (40+) — Purpose-built clinical and med-legal visualizations — that refuse to lie.
10. Background automations (24+) — It works the caseload while the practice is closed.
11. Trust, security & verification (30+) — Every signature is provable. Every tenant is isolated.
12. Platform & administration (40+) — Run the practice, not just the claim.

## Capability inventory (twelve groups)

### 01. Agentic AI & reasoning (137+ capabilities)
The reasoning is visible, verified, and never trusted blind.
- The Round Table — five specialist Digital Employees (Chiron, Issac, Justine, Eli, Theo) convened conditionally per case, in parallel, with graceful degradation
- Eve-Healthcare™ F5/reasoner — a compound five-component reasoning architecture, not a single model behind a prompt
- Chain-of-Verification — every specialist self-critiques (did I invent anything? what would opposing counsel argue?) before a physician sees the output
- Honest reasoning stream — a live, step-by-step trace of the real work, engineered to never fake a progress bar; the chain-of-thought never leaks to the transcript
- Ask the Case — grounded Q&A over the record and guideline corpus, inline citations, a hard guardrail that deletes any citation the reasoning did not retrieve
- Defend This — the system argues against its own determination as the defense QME, UR reviewer and carrier, then assembles a submit-ready defense packet
- Record digest — reads 1,000–3,000-page files whole (split-not-slice), segregates §4062.3 admissibility, then adversarially refutes every chronology entry
- Fail-toward-unverifiable verification — the schema cannot express "confirmed" on a failed check; unsupported claims are flagged, never deleted
- §4628 report drafting — 12 statutory sections, per-section specialist routing, page-anchored citations built from real anchors and verified back against source
- Apportionment legal-sufficiency engine — encodes Escobedo, Brodie/Strait §4664(b), Hikida, Almaraz-Guzmán against a registry that rejects invented authorities
- Glass-box tool-calling — one visible activity step per real operation (retrieval, compute, compose, persist), never a fabricated timer, never a model name
- Grounded RAG with citation verification, ICD-10 hallucination guard, and apportionment-citation validation
- One outbound compliance choke point — foundation-model-name suppression, AB-489 licensure-rewrite, PHI-minimization, reasoning-scaffolding scrub
- Shipped prompt-injection scorer — PHI-never-echoed, quarantine-vs-served discrimination, run live in-VNet weekly
- Human-in-the-loop by architecture — physician review/override on every determination; deterministic engines own every number the law requires exact

### 02. Clinical & EMR (60+ capabilities)
A real occupational-medicine chart, not a claims wrapper.
- Patient chart — demographics, problem list, medications, allergies, vitals (with BMI), each with add/edit/resolve lifecycles
- Encounters & visits — typed encounter intake, visit context, completion evaluation
- Medical records — blob-backed upload, AI extraction (diagnoses, findings, work-status, treatment history), amendment under 45 CFR 164.526
- Imaging analysis — AI medical-image analysis with modality-appropriate framing, radiologist-attested
- Treatment plans — plan + line-item authoring, revision, completion, per-item authorization requests
- Physician determinations — versioned, attestable, amendable
- Predesignation of personal physician — single-valid enforcement
- Medical Provider Network — §4616 verification, weekly refresh from the California DWC open-data feed
- Voice — dictation transcription and a realtime voice mode over the case

### 03. Case lifecycle & operations (70+ capabilities)
One system runs the whole file, intake to close.
- Eligibility & §3600 classification — industrial / denied / delayed / first-aid / non-industrial, versioned as the record develops
- Case intelligence dashboard — aggregated case detail, med-legal designation, determination summaries
- Case management — timeline, clinical-phase rail with adjacent-only transitions, MMI readiness, drift board
- Case Drift — flags cases lagging their predicted recovery trajectory before the file goes stale
- Signals — acknowledge / resolve / dismiss lifecycle with required-note discipline
- Morning Rounds — an overnight-worked worklist: what the system read, flagged and drafted while the practice was closed
- Records that react — a new document re-reads the case and refreshes the affected determinations
- Work queue — merged obligations and RFA work, board and list views, next-best-action
- Non-industrial redirection — care redirection with letter generation and referrals
- What-If scenario modeling — deterministic dollar-impact on the case’s own findings and the Labor Code constants that govern the number
- Case closure — settlement (C&R vs Stipulated Award), future-medical/MSA pathways, transition of care, guardrails that can only be overridden not "cleared"
- Closure & §5410 reopening — five-year reopen window computed and tracked so a case never closes blind to its reopen date
- Appointments — recurring series, status lifecycle, check-in, no-show detection

### 04. Causation & forensic (30+ capabilities)
The causation math is code, not a guess.
- AOE/COE causation analysis under Labor Code §3600, drafted from the full record and versioned first-draft to final
- §4663 apportionment — multi-factor analysis with normalization and fail-safe defaults
- §4664 prior-award offset — a deterministic engine on the Brodie/Strait three-prong test: exact, reproducible, versioned
- Impairment engine — Whole Person Impairment under AMA Guides 5th, DRE/ROM selection, Combined Values math, into a 2005 PDRS calculation
- Case-law grounding on every narrative — Escobedo, Brodie, Strait, Hikida, Almaraz/Guzmán
- Defensible narratives — every statement traces to the field in the record that produced it; reconstructable years later for deposition

### 05. Treatment, UR, IMR & appeals (45+ capabilities)
It scores the denial before the payer does — and builds the appeal.
- MTUS / ACOEM alignment — plans checked against two dozen authentic California DWC guideline documents at the point of care, with citations
- UR Survival Score — denial and IMR-appeal risk scored before the RFA goes out, with the evidence to attach named
- RFA lifecycle tracking end-to-end; §4610(g)(2) auto-authorization detection; denial-risk drivers surfaced inline
- Dubon / Bodam denial classification gating IMR eligibility vs a straight appeal
- IMR packet assembly under §4610.5, timed against the 30-plus-5-day mail clock, with exhibit auto-proposal
- UR decisions capture and classification; treatment authorization insights (suggest-MTUS, UR-insights) with glass-box reasoning

### 06. QME / AME / med-legal (120+ capabilities)
The panel process runs like a state machine, not a spreadsheet.
- §4628 QME report — twelve required sections drafted, section-locked until prior sections are physician-approved, checked against a compliance checklist
- §4062.1 / §4062.2 panel process — QME and AME panels as a state machine, strike tracking, the Vázquez good-cause exhibit generator (byte-stable)
- PTP/QME reconciliation — treating-physician determination reconciled line-by-line against QME/AME findings, disagreement surfaced not overwritten
- QME intake questionnaire — worker pre-evaluation intake feeding report prefill; §4664 prior-claim flagging as unconfirmed candidates
- §4628 admissibility — §49 time itemization with specialty face-to-face minimums, service-performer disclosure, records-reviewed exhibit with §9795(c) page reconciliation
- Information exchange (§4062.3 / §35) — package service, 20-day clocks, objection and WCALJ-order handling, ex-parte classification (Suon en banc)
- Report service (8 CCR §36) — recipient matrix by case shape, §38 30-day clock, declaration of service, serve-by-fax
- DEU rating (§4061) — 20-day rating and 30-day reconsideration clocks; factual corrections (DWC Form 37, §4061.5)
- Sub-rosa (ML205) and testimony (ML204) — §35 information-gate, quarter-hour billing, §35.5(f) deposition-notice deadlines
- AME agreements; secondary-provider report integration with 20-day clocks; case-party (adverse-party) register
- On-demand DWC / DEU / CMS form rendering — 21 forms scoped to case, panel, evaluation and billing

### 07. DWC reporting & deadlines (35+ capabilities)
Every DWC clock, tracked to the business day.
- Form 5021 — Doctor’s First Report, drafted against the 5-business-day deadline
- PR-2 progress reports — auto-drafted on the 45-day cadence or on a material change; the physician edits every section
- P&S / MMI under §4061 — triggered by the clinical milestone, deadline-tracked, physician-attested
- Deadline engine — every statutory clock encoded and holiday-aware against the California calendar; a daily 07:00 sweep surfaces every approaching and overdue report
- Reporting-obligation service matrix; secondary-report obligations; transmission-gap alerts
- AB 3030 attestation on every AI-drafted report — non-dismissible, persists through the signed PDF

### 08. Billing, revenue & MLFS (47+ capabilities)
Coded to the fee schedule. Chased to the penalty.
- OMFS coding on every billable encounter; E/M coding leveled on the CMS 2021 Medical Decision-Making rules
- Medical-Legal Fee Schedule (8 CCR §9795) — the full ML-200…ML-205 catalog, first-200-page thresholds, $3/page MLPRR excess, §9795(c) perjury page-count verification
- ML204 testimony billing ($113.75/¼hr, 2-hour minimum, lesser-of usual fee) and ML205 sub-rosa review ($81.25/¼hr)
- §4603.2 penalty & interest — the 45-business-day pay rule tracked; penalty and interest computed the moment a payer misses it
- Explanation-of-Review ingestion and structured extraction; the §4622 90-day clock anchored to the EOR date
- Second Bill Review → Independent Bill Review appeal ladder; CMS-1500 and medical-legal bundle generation
- Clearinghouse claim submission (X12 EDI); payment events and tracking; immutable billing audit trail; carrier performance analytics

### 09. Data visualization & glass-box UX (40+ capabilities)
Purpose-built clinical and med-legal visualizations — that refuse to lie.
- §4663 apportionment waterfall — whole-disability reference down to the industrial remainder, refusing to draw an unweighed factor
- §4062.3 record-chronology timeline — admissible records on a time axis, contested and undated entries handled honestly
- Work-status restriction bands (DWC-AD 10133.36) on a duration axis
- QME panel deadline horizon — a diverging statutory-clock axis centred on today, overdue in alarm ink
- Every chart carries a mandatory text-equivalent and declines to draw on a failed read rather than assert a false picture
- Glass-box streaming reasoning surface reused across closure, QME drafting, apportionment and PTP-QME

### 10. Background automations (24+ capabilities)
It works the caseload while the practice is closed.
- 16 per-tenant monitors — closure windows, intake retention, case drift, RFA/UR §4610 clocks, reporting-obligation deadlines, IMR filing clocks, QME/AME panel windows, billing deadlines, breach detection (every 5 min), appointment no-show, and more
- 6 durable queues — document extraction, intake identity extraction, whole-file record digest for QME-scale cases, PTP-QME comparison, QME finding extraction, QME record organization
- A durable job-run substrate with a replayable glass-box trace you can re-attach to across navigation
- A weekly in-VNet prompt-injection evaluation that runs the live guardrails against an attack corpus

### 11. Trust, security & verification (30+ capabilities)
Every signature is provable. Every tenant is isolated.
- Public cryptographic verification — four no-login, zero-PHI, rate-limited endpoints (IMR, QME, PTP-QME, closure); a SHA-256 hash binds the attestation to the exact rendered PDF
- Fail-closed tenant isolation — Postgres row-level security under a non-superuser role across ~145 tables, plus tenant-scoped blob storage, plus defense-in-depth explicit filters
- A four-level per-case access kernel (read-only / consulting / treating / owner) with a billing-only side-channel that can never read clinical data
- Immutable PHI access log written by decorator, not developer discipline — tamper-evident by construction
- Breach detection mapped to HIPAA notification triggers — failed-auth bursts, cross-tenant attempts, mass-export patterns
- AI-use disclosure per CA AB-3030 / AB-489; tenant-wide MFA with break-glass; PHI-safe logging and telemetry throughout

### 12. Platform & administration (40+ capabilities)
Run the practice, not just the claim.
- Clinic provisioning, user and role administration, session management, MFA reset
- Analytics — practice and med-legal dashboards, physician-agreement tracking as an operational trust metric
- Notifications — in-app and email with per-user preferences and deterministic de-duplication
- Document intake triage, misfile register, records-request tokenized upload links for outside parties
- In-app help — a 98-article library with acronym-aware search, shared verbatim with Chiron’s own help tool, plus guided tours
- Tenant data rights — DSAR export with a verifying manifest and certified destruction (BAA §6.3 / §8.2); compliance/BAA/breach registers; in-product support queue

## Where to learn more
- Full capabilities page: https://chirongrid.ai/om/capabilities/
- OM overview: https://chirongrid.ai/om/
- Reasoning architecture: https://chirongrid.ai/technology/f5-reasoner/
- Trust, security & compliance: https://chirongrid.ai/trust/
- Book a demo / contact: https://chirongrid.ai/contact/