Nousvia Health
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Enterprise Technical Architecture • nhCoder Engine

The Nousvia Intelligence Core: Hybrid Tiered AI + Deterministic Rules

Engineered for zero-tolerance healthcare compliance. Combining deterministic lexical matchers, high-speed ML complexity models, and multi-agent LLM reasoning on Databricks Unity Catalog.

Schedule Architecture BriefingReview HIPAA & SOC 2 Safeguards
HIPAA & HITECH Compliant
Signed Enterprise BAA
SOC 2 Type II Certified
Annual 3rd-Party Audit
HITRUST CSF Aligned
Healthcare Security Benchmark
SMART on FHIR Native
Epic & Cerner Certified
96.8% Audit Accuracy
Exceeds AHA Standard
Interactive Architecture Simulation

Inside the nhCoder Autonomous Pipeline

Walk step-by-step through our real-world emergency medicine coding pipeline. Observe clinical section parsing, MDM complexity classification, vector code candidate search, and deterministic NCCI modifier assignment in real time.

nhCoder Architecture Engine v4.2
NousviaHealth / nhCoder • Hybrid Tiered System
Stage 01 of 06

Clinical Ingestion & Section Parsing

clinical_coding.medical_agents.parser
Execution Latency36ms
Confidence Score99.9%
Architecture TierDeterministic Core

Continuous streaming intake of HL7 v2 MDM/ORU feeds, SMART-on-FHIR R4 resources, and unstructured ED notes normalized by the SectionParserEngine.

Raw ED Physician Progress Note (Epic EHR Feed)SMART-on-FHIR R4 / DocumentReference
CHIEF COMPLAINT: Crushing substernal chest pressure radiating to left jaw, onset 45 min prior to arrival. Diaphoretic, nausea.
PAST MEDICAL HX: HTN, hyperlipidemia. Denies prior MI or CAD.
PHYSICAL EXAM: BP 168/96, HR 104, SpO2 94% room air. Patient appears in acute distress. S1/S2 tachycardic, no murmurs. Lungs clear bilaterally.
ED COURSE & MDM: 12-lead ECG demonstrates 3mm ST elevation in leads V2-V4. Urgent Cardiology consulted. IV Nitroglycerin, Heparin bolus initiated. Bedside 4.2cm left forearm skin laceration repaired with 4-0 Ethilon simple interrupted sutures under 1% lidocaine.
DISPOSITION: Emergent Cardiac Catheterization Lab activation. Transfer to CCU.
Decision Strategy

The 4-Tier Hybrid Execution Pipeline

Why pure LLMs fail in medical billing: How nhCoder enforces deterministic accuracy before invoking generative models.

0ms Latency • 100% Deterministic

Tier 1 • Deterministic Heuristic KB Matcher

Applies compiled medical lexicons, KeywordMatcher, and NegationDetector across clinical chart text. Flags explicit diagnosis mentions and historical rule-outs without token cost or stochastic variance.

Resolves ~42% of common clinical findings instantly
Sub-20ms • Curated Regex Rule Packs

Tier 2 • Domain-Pattern Contextual Engine

Executes specialized regular expression rule packs designed for acute symptom complexes, bedside vital sign instability, and point-of-care laboratory alerts to build immutable signal accumulators.

Extracts 14+ structured clinical complexity indicators
LightGBM & XGBoost • Trained on 12M+ Charts

Tier 3 • ML Clinical Complexity Extractor

Evaluates the CMS Medical Decision Making (MDM) 2-of-3 criteria (Problems Addressed, Data Analyzed, Risk of Morbidity). Assigns ED Facility Levels (CPT 99281–99285) with calibrated confidence gating.

96.8% autonomous pass rate on ED encounters
Claude Opus/Sonnet • Gated <95% Confidence

Tier 4 • Multi-Agent LLM Reasoning Fallback

When an encounter falls below the 95% MLDecisionGate threshold, specialized medical agents (Diagnosis, Procedure, Chart Info) perform clinical cross-talk and generate explainable audit rationales.

Invoked only on ambiguous edge cases and polytrauma
System Architecture

Engineered in 4 Defensible Layers

How clinical notes transform into audit-ready financial transactions without human data re-entry.

LAYER 01 // INTEROPERABILITY GATEWAY
Median Ingestion Latency: < 45ms

Healthcare Interoperability & Ingestion Layer

Continuous streaming ingestion of structured and unstructured clinical records using certified SMART-on-FHIR R4 APIs, HL7 v2 MDM/ORU feeds, and native EHR hooks. Ingests physician progress notes, operative reports, bedside flowsheets, and historical EDI 835/837 remittances with zero human re-entry.

Core Architectural Capabilities

Bidirectional SMART-on-FHIR R4 certified integration
Automated HL7 v2.5.1 MDM/ORU real-time message parsing
Zero-ETL streaming into Delta Live Tables with ACID guarantees
Automated HIPAA Safe Harbor de-identification and mTLS 1.3 encryption
Certified Protocols & Standards:
FHIR R4HL7 v2.5.1EDI 837/835DICOM-SRJSON-LD
EHR Inbound Stream Listener // Real-time Ingestion
STREAM ACTIVE • 0 DROPPED PACKETS
Ingestion ProtocolSMART-on-FHIR R4 (mTLS 1.3)
Payload TypeDischarge Summary + Operative Notes
FHIR ResourcesEncounter, Condition, Procedure
Target BufferDelta Bronze Stream (Streaming Live)
De-ID Pipeline100% HIPAA Safe Harbor Clean
GET /fhir/r4/Encounter/ENC-2026-98124/DocumentReference
HTTP/2 200 OK
Content-Type: application/fhir+json
X-Nousvia-Ingest-Hash: sha256:4a8f9c...
Status: 100% Validated (HL7 v2 MDM Mapped)
Pipeline Progression:
Databricks Lakehouse • Unity Catalog Architecture

Governed, Auditable Delta Lake Lineage

Built directly on Databricks Unity Catalog and Delta Lake, nhCoder ensures total regulatory governance across the entire clinical data lifecycle. Every pipeline transformation—from Bronze raw ingestion through Silver fact extraction to Gold claim generation—is immutably versioned with MLflow.

Delta Live Tables (Bronze / Silver / Gold)
Zero data duplication, automated idempotent retries, and schema evolution.
MLflow Experiment Tracing & Run Lineage
Captures prompt versions, model weights, latency metrics, and coder feedback.
Unity Catalog Column-Level Access Control
HIPAA and SOC 2 Type II compliant RBAC masking all sensitive patient identifiers.
unity_catalog_manifest.sql
LIVE_PROD
-- Unity Catalog Lineage Pipeline
CREATE OR REFRESH STREAMING TABLE
  gold_autonomous_claims
AS SELECT
  chart.correlation_id,
  chart.account_number,
  em.facility_em_code,      -- 99285
  post.resolved_modifiers,  -- ['-25']
  diag.primary_icd10,       -- I21.09
  gate.confidence_score,    -- 0.9862
  gate.filing_disposition   -- DIRECT_TO_BILL
FROM
  STREAM(silver_chart_context) chart
JOIN
  silver_em_levels em ON chart.id = em.chart_id
JOIN
  silver_post_coding post ON chart.id = post.chart_id
JOIN
  gold_ml_decision_gate gate ON chart.id = gate.chart_id;
EHR Ecosystem

Seamless Integration with Leading Health IT Platforms

Go live in 4 to 8 weeks with pre-built bi-directional connectors.

Epic Systems

Certified SMART-on-FHIR App

Hyperspace, Cadence, Resolute Hospital & Professional Billing, In Basket CDI queries

Oracle Health / Cerner

Cerner Ignite Certified

PowerChart, Millennium, Patient Accounting, Message Center integration

MEDITECH Expanse

FHIR Restful API Native

EHR, Revenue Cycle, Clinical Documentation and HIM Worklist interface

Athenahealth

Marketplace Partner Connected

athenaCollector, athenaClinicals, Real-time Claim Scrubber & Authorization Hook

Veradigm / Allscripts

API Integrated

TouchWorks, Sunrise Acute Care, Professional Billing interfaces

Clearinghouses

Bi-directional 835 / 837 EDI

Waystar, Experian Health, Change Healthcare, Availity, Optum Clearinghouse

Forensic Audit Trail & Zero-Trust

Every Code Assignment is 100% Explainable

In a RAC audit or commercial payer dispute, black-box AI is a liability. Nousvia generates a cryptographic, time-stamped evidence card for every single assigned diagnosis and procedural modifier, linking to the exact sentence written by the attending physician.

Explore Trust & Security Center
Enterprise-Ready • Epic & Cerner Compatible

Deploy Nousvia in Your Health System Sandbox

Test our SMART-on-FHIR connector in your test environment with synthetic patient records in under 48 hours.

Request Sandbox AccessCalculate Health System ROI