c2141a127a
- Remove 'coverage' from worklist description across all docs - Add whitepaper v2, documentation gap whitepaper, gate demo, sample - Add TERAX.md, Claude Code settings, test-data generator - Add settings.local.json to .gitignore Co-Authored-By: Claude Sonnet 4.6 <noreply@anthropic.com>
121 lines
5.4 KiB
Markdown
121 lines
5.4 KiB
Markdown
# Signal — Asset Package | Executive Summary
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**STTIL Solutions LLC | Confidential | April 2026**
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---
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## Market Opportunity
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The CGM DMEPOS market is entering a window of structural stress that rewards
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suppliers with proactive coverage management tooling.
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- **2028 Competitive Bidding (CB):** CMS is expanding CB to CGM categories.
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Margin compression will accelerate. Suppliers that reduce denials and appeals
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overhead gain a direct cost advantage over competitors still running manual,
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reactive workflows.
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- **Prior Authorization Expansion (April 13, 2026):** CMS implemented expanded
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PA requirements for CGM and related DMEPOS categories. Every prior auth cycle
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introduces a coverage gap risk. Suppliers need automated visibility into
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those gaps to act before a claim touches a PA trigger.
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- **Enrollment Moratorium:** CMS supplier enrollment moratoria in high-risk
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areas are tightening the supply pool. Existing enrolled suppliers face
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consolidation pressure and rising per-patient management burden — exactly
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the problem Signal is designed to reduce.
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- **Denial Patterns:** CGM claims deny on predictable, preventable conditions:
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coverage lapsed before refill, physician visit not renewed on the Medicare
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180-day cycle, quantity exceeds allowable without documentation. Signal
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flags all three before shipment, not after.
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The total addressable market is approximately 7,500 Medicare-enrolled DMEPOS
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suppliers billing CGM. A conservative 1% penetration at $3,600 ARR = $2.7M ARR.
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CMS projects CGM beneficiaries to exceed 3.2 million by 2028.
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---
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## What Signal Does
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Signal is a B2B documentation worklist tool built for DMEPOS supplier back-office
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teams. It replaces manual spreadsheet tracking with an automated, rule-driven
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coverage clock.
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- **Coverage Clock:** Calculates coverage expiration per patient per device
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using payer-specific wear-day rules (Dexcom G6/G7, Libre 2/3, Omnipod 5).
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Medicare visit renewal (180 days) is tracked as a separate flag.
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- **24-Hour Batch Worklist:** n8n orchestration runs nightly. Staff arrive to a
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sorted worklist — `OUT_OF_COVERAGE`, `VISIT_DUE`, `REFILL_WINDOW`, `OK` —
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with highest-urgency patients at the top.
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- **Minimal PHI Surface:** The system ingests `patient_id`, `device_type`,
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`shipment_date`, `quantity`, `payer` only. No names, SSNs, DOBs, or contact
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information enter the system. The supplier's own staff map `patient_id` back
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to identity in their existing systems (Brightree, EHR). All audit logs hash
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identifiers before storage.
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- **Self-Hosted:** Runs on supplier's own VPS or STTIL-managed Hostinger VPS.
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Data never leaves the supplier's network. No third-party SaaS dependency
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on the data path.
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---
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## What's Included in the Sale
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| Asset | Description |
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|-------|-------------|
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| Full source code | Python/FastAPI backend, coverage calculator, audit logger, PostgreSQL models, payer rules config |
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| Research library | DMEPOS market research v3, compliance roadmap v1, CB/PA regulatory analysis |
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| BAA templates | Hostinger VPS BAA request template; operator BAA framework for customer agreements |
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| Newsletter strategy | Subscriber acquisition strategy for DMEPOS supplier outreach (v1) |
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| n8n workflows | Self-hosted batch trigger workflow exports |
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| `CLAUDE.md` handoff | Full AI-assisted development context file — new owner can continue building with Claude Code with zero ramp-up loss |
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| 30-day knowledge transfer | Live sessions with STTIL Solutions founder covering architecture, payer rule updates, compliance posture, and go-to-market |
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Buyer receives all intellectual property, documentation, and development context
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as a clean, working asset. No vendor lock-in. No ongoing royalty.
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---
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## Ideal Buyer Profile
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**Option A — DMEPOS Supplier (Direct User)**
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A mid-size supplier billing 200–2,000 CGM patients/month who currently manages
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coverage tracking in spreadsheets or Brightree custom fields. Immediate ROI
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through denial reduction. Can deploy internally or white-label for peer suppliers.
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**Option B — Healthcare Operator / DME Platform**
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A DMEPOS software vendor, billing company, or managed services operator looking
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to add a differentiated coverage intelligence module to their existing platform.
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Signal integrates cleanly into existing FastAPI or Django stacks.
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**Option C — Consortium or Buying Group**
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A DMEPOS buying group or GPO representing multiple suppliers. Acquire once,
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deploy across member base. License to members as a value-add service. Buying
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groups operating in markets with active CB expansion have the strongest urgency
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case.
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---
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## Investment Range
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**$25,000 — $60,000** (one-time asset acquisition)
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Range reflects buyer type and included transfer scope. Direct supplier buyers
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at the lower end. Platform/operator buyers and consortium structures at the
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higher end. All terms negotiated directly with STTIL Solutions LLC.
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No SaaS subscription required. No ongoing royalty. Buyer owns the asset outright.
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---
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## Why Now
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- PA expansion is live as of April 13, 2026 — suppliers are feeling it now
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- CB 2028 planning cycles begin at the supplier level 18–24 months out
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- The enrollment moratorium is reducing the number of new entrants who can
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absorb this problem with headcount — existing suppliers must solve it with tools
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- Early buyer gets the asset before it is offered to competitors in their market
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- 30-day knowledge transfer window is time-limited and not guaranteed after
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initial close
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---
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## Contact
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[CONTACT PLACEHOLDER]
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