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The vignette

A 63 year old patient. Severe concussion. New onset depression.

Most mental health care waits for the crisis to come to us. COGAI Medical catches it at the spark. This is what that looks like in a real practice.

Anchor story · Dr. John Abrahams

What actually happened

Sixty three year old patient. Severe concussion. New onset depression underneath. COGAI Medical alerted the team that his depression was worsening over a three month cycle. The R Score kept falling.

The team opened a LiveChat thread to reach him and realized he had stopped refilling his anti depression medication. His family was thankful. Once the medications were back on schedule, he was doing much better.

That is what this tool does. It catches the spark before the fire.

What we believe

Five beliefs the product is built on.

Care should be proactive. The instruments to deliver it already exist. The clinician's time is the bottleneck. Population health is a workflow, not a dashboard. The privacy architecture is the same across use cases.

  1. 01

    Most mental health care is reactive. It should not be.

    Patients show up when they are already in crisis. Monthly population level screening catches the spark before it becomes a fire.

  2. 02

    The screeners that define good psychiatric care already exist.

    PHQ 9. GAD 7. PCL 5. DAST 10. AUDIT. PSQI. Every clinician knows them. What did not exist was a panel view that ran them monthly across an entire population and handed a provider a twelve month trend before the visit started.

  3. 03

    The clinician's time is the bottleneck.

    Screening done before the patient arrives. Thresholds pre wired. Panel sorts by R Score. Notes, referral log, and the weekly schedule cadence one click away. The twelve week high risk check in is templated.

  4. 04

    Population health is not a dashboard. It is a workflow.

    Screen. Flag. Clinician acts. Secure messaging thread opens or referral fires. Next cycle measures whether anything changed. A dashboard reports. A workflow moves patients.

  5. 05

    The same privacy architecture works across use cases.

    Consent per user, revocable. Identified access restricted to the Medical Provider role. AI non diagnostic and non emergency. The guardrails do not weaken when we move between use cases. They carry over.

Seven validated instruments

The same battery every clinician already uses.

Run monthly. Sorted by R Score. Clinical thresholds pre wired. The screening is done before the patient walks in.

  • PHQ 9

    Depression

  • GAD 7

    Anxiety

  • PCL 5

    Trauma

  • DAST 10

    Drug use

  • AUDIT

    Alcohol use

  • PSQI

    Sleep

  • WORK

    Work wellness

Medical Provider console

Screen. Flag. Act. Measure.

The Medical Provider role is the only role that resolves individual identity to a score. Scoped, logged, and auditable. A dashboard reports. This is a workflow.

  • 01

    Panel sorted by R Score

    Composite wellness metric across all seven instruments. Zero to one, lower is better. The patient with the most urgent picture is row one. The trend line is visible without drilling in.
  • 02

    Clinical thresholds pre wired

    PHQ 9 ≥ 15. GAD 7 ≥ 15. PCL 5 ≥ 50. The flags are not a guess. They are the same thresholds the literature defines.
  • 03

    Twelve month trend on every patient

    Each patient carries a twelve month trend on every instrument. Treatment response, remission, and relapse all show up on the same chart. The visit starts with the data already loaded.
  • 04

    LiveChat with crisis protocol threads

    Encrypted secure messaging. The clinician opens a thread the moment a flag fires. Start a crisis protocol thread is a one click action.
  • 05

    Twelve week high risk check in

    Templated. Activated with one button on the patient profile. Weekly cadence runs automatically through the recovery window. Clinical Notes, referral log, and Recent Activity sit alongside.

Two use cases. One product.

Same tech stack. Different deployment. Same privacy architecture.

The product difference is the routing layer, not the measurement layer.

Use case A

Medical clinics

Practice administrators, medical directors, and directors of behavioral health at multi site clinics or behavioral health groups. The panel view sorts by R Score with clinical thresholds pre wired. LiveChat routes a flagged patient to a clinician without a three system scramble. Medical directors care for a larger panel without missing the people who are declining.

COGAI Medical — request a demo →

Use case B

Small insurance plans

Medical directors, VPs of care management, and the care team at small insurance companies. Proactive population health on the membership without an EAP hotline deflection. Medication compliance up. ER admissions down. HEDIS depression and follow up measures move. Per patient per month pricing.

For insurance plans — scope a pilot →

For insurance plans

Proactive care, priced per patient per month.

Members do not show up to behavioral health care until they are in crisis. COGAI Medical catches them before the crisis. The underlying software works across both use cases. The go to market for the insurance company use case is being co designed with our first prospective client.

01

Medication compliance

Members at risk of stopping a behavioral health medication are surfaced before the gap. The clinician reaches them through LiveChat. Adherence improves on the panel level.

02

ER admissions

Behavioral health crisis events that present in the ER are an expensive failure mode. Catching the spark earlier reduces the downstream pattern of crisis ER visits tied to anxiety, depression, and substance use.

03

HEDIS measures movement

Follow up after positive screen. Response at six and twelve weeks. Remission tracking. The metrics CMS and NCQA already expect. The product is designed to move them.

04

Workflow leverage

The same care management team can carry a larger panel because the panel arrives sorted. Stratified, with thresholds, with twelve month context. The work goes to the members who need it most.

Specific percentages are confirmed against the plan's own panel during pilot scoping. Outcome categories are designed targets for the product, not delivered claims.

Workers compensation

The first proof point for a third party sponsor model.

Mental health complications are the dominant driver of prolonged recovery after a work related injury. Untreated anxiety, depression, PTSD, and sleep disturbance extend time off, increase reinjury risk, and inflate claim cost. A carrier sponsors. The injured worker owns the clinical relationship. Clinical outcomes go to the carrier under a narrower permitted use.

COGAI Medical is not a pain management tool. It surfaces the mental health signal that drives the extended recovery curve.

  • 01

    Screen at claim open

    Validated instruments administered shortly after the claim opens. The baseline is set. The trend line has a start.
  • 02

    Stratify by R Score

    The member panel is sorted by R Score and by instrument flags. Claims with a rising trajectory are visible before the claim runs long.
  • 03

    Route to care

    Members above threshold are routed to the plan's behavioral health benefit or to Cognifica Health under BAA.
  • 04

    Track recovery

    Instruments run on a cadence through recovery. Response and remission are visible to the clinical team, priced per claim or per episode.

Crisis protocol

Automated the moment a patient clears threshold.

The escalation does not wait for a human to notice. The Medical Provider role is paged, LiveChat is open, and the twelve week high risk check in is one click away.

  1. 01

    Real time clinical alert

    Crisis flag fires on submission. The Medical Provider role is paged immediately. Not at the end of the day.

  2. 02

    LiveChat thread opens

    Encrypted secure messaging. The clinician initiates the conversation inside the boundary, with the trend visible.

  3. 03

    Warm handoff to 988

    When appropriate, the counselor facilitates the handoff to 988 or local emergency services on the line. 988 is visible on every screen.

  4. 04

    Twelve week high risk check in

    Templated. Activated with one button. Weekly cadence runs automatically through the recovery window.

AI posture

A clinician hearing AI in a mental health product is more cautious than an HR leader. They should be.

AI in COGAI Medical helps structure the conversation and spot patterns across instruments and across time. It does not diagnose, it does not treat, it does not decide.

Identified access is restricted to the Medical Provider role. Every clinical action is initiated by a human. The line is in the consent document, not just the marketing.

From the founder

Built for my own clinic. Now, for yours.

Dr. John Abrahams, founder. Practicing neurosurgeon. Susan Mogan, PMHNP, leads behavioral health delivery. The product runs every day inside Cognifica Health, an active practice in Aquebogue and West Harrison, New York.

“I cannot look at every patient’s mood and mental health assessment between visits. This shows me who needs me first. When a patient in a Cognifica clinic crosses a threshold, they can route straight into my own waiting room. That is not hypothetical. That is how the system works.”

Dr. John Abrahams · Founder

Pricing

Two pricing models. One product.

Clinics buy seats. Insurance plans and workers comp carriers buy panels. Both rates are confirmed at pilot scoping.

COGAI Medical

Seat based · four tiers

XS · SM · MD · LG. Same tier structure as the workforce product.

$TBD / seat / month

For insurance plans and carriers

Per patient per month

Plan size, panel shape, and the instruments in scope drive the rate. Workers comp prices per claim or per episode.

$TBD / patient / month

FAQ

What we are usually asked

What is the difference between COGAI Medical and a chart review tool?

+

A chart review tool reports. COGAI Medical is a workflow. Screen, flag, clinician acts, LiveChat thread opens or referral fires, next cycle measures whether anything changed. A dashboard tells you the past. A workflow moves patients in the present.

Why these seven instruments?

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PHQ 9 for depression, GAD 7 for anxiety, PCL 5 for trauma, DAST 10 for drug use, AUDIT for alcohol use, PSQI for sleep, plus a work wellness scale. Every clinician in this field already uses them. The thresholds are defined in the literature. We pre wire them so triage is consistent across providers.

What is the R Score?

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A composite drawn from the seven validated screeners. Zero to one, lower is better. The clinician sees individual R Scores in a sortable panel. Trends carry twelve months of context. R Score movement starts the conversation. The instrument breakdown closes it.

How does AI work inside COGAI Medical?

+

AI helps structure the conversation and spot patterns across instruments and across time. It does not diagnose, it does not treat, it does not decide. Every clinical action is initiated by a human. The line is in the consent document, not just the marketing.

We already have a behavioral health vendor.

+

Behavioral health vendors typically deliver care. COGAI Medical identifies. The two sit together, not on top of each other. For plans without a clinical delivery arm, Cognifica Health is available for delivery under BAA.

Our care management team already does this.

+

Care management typically engages members after a claim signals a problem. COGAI Medical engages before. Validated instruments on a monthly cadence surface members whose trajectories are shifting, and deliver them into care management with a composite score and a visible trend.

How does the consent work for an insurer sponsored deployment?

+

The clinic facing consent names the clinical entity as sponsor. For an insurer sponsored deployment, a parallel consent names the insurer as sponsor with appropriate permitted use language. That document is being co authored with counsel. The same architectural rule holds: identified access is restricted to the Medical Provider role.

What about EMR integration?

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Most clinics start without EMR integration. The Medical Provider console runs alongside the chart and the panel data is exportable. Direct EMR integration is on roadmap. The pilot does not require it.

Patients say it is yet another survey.

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The cycle is eight minutes a month and the patient sees their own R Score and trend immediately. Completion in seeded tenants runs above ninety percent because something comes back. It is not a survey. It is a check in with feedback.

What about workers compensation?

+

Workers comp is the closest existing adjacency to a payer deployment. The carrier is the third party sponsor. The injured worker owns the clinical relationship. Clinical outcomes go to the carrier under a narrower permitted use. Pricing is per claim or per episode. We treat workers comp as the first proof point that COGAI Medical can operate under a third party sponsor model.

COGAI Medical

Walk the Medical Provider console with a clinician.

A clinician will be on the call. We open a real anonymized panel, show the R Score sort, the twelve month trends, the LiveChat thread, and the crisis flag path. Forty five minutes.

  • Medical Provider console walk through
  • R Score sort and clinical thresholds
  • Crisis protocol live
  • Pilot scoping, if the fit is right
Or call (914) 705 6830

Medical Group Inquiry

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For insurance plans

Scope a pilot against your own panel.

A clinical operator and the founder are on the call. We look at the panel shape, the HEDIS measures in scope, the permitted use posture, and the pricing axis. Forty five minutes.

  • Panel scoping and enrollment model
  • HEDIS depression and follow up in scope
  • Per patient per month proposal
  • Workers comp adjacency, if relevant

Payer Inquiry

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