An AI-native practice intelligence platform

Built by a physician who got tired of cosigning notes at 11pm.

CosignMD is the AI layer for the rest of your practice — notes, calls, messages, faxes, prior auth. One login. One system that actually talks to itself. Built during rounds, not in a boardroom.

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No EMR integration. No IT ticket. Live at multiple hospitals.
Tuesday · 4:42pm · Room 312
● Handled
4:31p
CallPharmacy requesting clarification on azithromycin duration.
4:32p
AIDrafted reply referencing today's note. 5 days, completing Friday.
4:35p
NoteAcute respiratory failure flagged — missing type and etiology.
4:38p
FaxPA draft ready for review — PulmRehab, aetna commercial.
4:42p
DoneThree tasks. No tabs. No copy-paste. No 11pm.

PHOTO · 01 2026 Alfredo Lee Chang, MD · Pulm/CC
A note from the founder
I'm Alfredo Lee Chang, a pulmonologist and intensivist. For years I thought my problem was the notes — that if I could just finish charting by 11pm, I'd have my life back.

Then one Tuesday I finished a note at 10:45. I still had three voicemails, a fax I never saw, and a prior auth my staff had re-drafted twice. The notes weren't the problem. The notes were just the last thing I did every day, after surviving everything else.

I tried every tool on the market. Each one fixed one thing and ignored the other five. So I built the thing I actually needed — one system where the note, the call, the fax, the message, and the PA all know about each other. Because they're all me.
Alfredo Lee Chang, MD Pulmonology · Critical Care
One layer. Six tools retired.

The rest of your stack, replaced.

Independent physicians run their practice on six separate subscriptions that don't talk to each other. CosignMD is the layer that retires all of them, with one context the AI actually understands.

Before · six tools, six logins

  • AI scribe $99–700/mo
  • Patient messaging $200–400/mo
  • Call management $300–800/mo
  • Fax / Rx service $100–250/mo
  • Staff messaging $150–400/mo
  • Prior auth labor $500–2,000/mo

After · one layer

CosignMD
Practice intelligence, one login
AI clinical notes with defensibility review
Inbound + outbound call management
Patient text + staff messaging
Fax & Rx coordination
Prior authorization drafts
Physician-portable — your license, not theirs
What it actually does

Three surfaces. One context.

The advantage isn't that it does six things. The advantage is that the AI knows what happened on the other five when you ask about the sixth.

01 / CLINICAL NOTES

Defensibility catches the queries before they hit your inbox.

Type, etiology, acuity, link to treatment — flagged before you sign. Billing codes suggested with severity and rationale. Not a checklist. A read of your note the way an auditor reads it.

acute_respiratory_failure
→ missing: type (hypoxic / hypercapnic)
→ missing: etiology
→ E/M suggestion: 99223 (high MDM)
02 / COMMUNICATIONS

Calls, texts, and faxes that draft their own replies.

Incoming pharmacy call gets AI-transcribed, cross-referenced against today's note, and a draft reply is ready before you check your phone. Patient texts triaged by clinical urgency, not arrival time.

call_inbound
→ transcribed · 11 sec
→ draft reply ready
→ you tap send
03 / PRIOR AUTH & RX

Prior auths drafted from the chart that justified the order.

The PA draft pulls from the note you already wrote. Diagnosis, medical necessity, prior treatments tried — assembled. You review, sign, fax. Built to cut the 30 minutes your staff spends reconstructing context.

pulm_rehab · aetna
→ pulling from today's note
→ prior trials: beta-agonist, ICS
→ PA draft · review & sign
Who this is for

If any of these sound like you.

CosignMD is built for a specific kind of clinician. If it fits, you'll feel it in the first session.

  • You finish your charts after your kids are in bed.
  • You pay for three or more tools that don't talk to each other.
  • You've been queried for vague documentation more than once.
  • You want your practice data to belong to you — not your hospital.
  • You'd rather pay one platform than orchestrate six.
The questions every physician asks

Answered, plainly.

"Is my patient data safe?"
CosignMD is HIPAA-compliant. PHI is encrypted at rest and in transit, and your notes are never used to train AI models. We operate as a Business Associate under your license. Full BAA published at cosignmd.ai/baa.
HIPAA BAA published No training data AES-256 at rest
"Do I have to change my EMR?"
No. CosignMD runs alongside your EMR, not inside it. Works with Elation, Epic, Cerner, Athena — any of them — because it doesn't require integration. Paste, dictate, or forward. No IT ticket. No admin onboarding. If you can use email, you can use this.
Any EMR Browser-based No IT approval
"Who owns my data if I change jobs?"
You do. CosignMD is physician-portable by design. Your license, your history, your patient communication records — they travel with you, not with the practice or hospital that employs you. If a hospital buys your group tomorrow, your CosignMD account stays yours.
Physician-owned Portable license Export anytime
"What if I don't love it?"
The founding physician cohort includes a free trial period and a no-questions cancellation. We want physicians who actually use it. If it's not saving you at least an hour a day by the end of month one, it's not for you — and you don't owe us anything.
Free trial Cancel anytime No contract
Founding physician cohort

A small group of physicians shaping the next year of the product.

Founding physicians get direct access to the founder, lifetime-locked pricing at $99/mo, and a seat at the table on what gets built next. In exchange, we ask you to actually use it and tell us what's broken.

This isn't a launch funnel. It's a handful of physicians helping shape a platform before it opens to everyone. Spots are limited by how many people one founder can personally support.

Early Adopter
Early Adopter
$149/mo

For physicians who join after the founding cohort fills.


Full platform accessIncluded
Physician-portable accountIncluded
Onboarding call30 minutes
CancellationAnytime
Standard
Standard
$349/mo

Ongoing rate for new subscribers once early access closes.


Full platform accessIncluded
Physician-portable accountIncluded
Onboarding call30 minutes
CancellationAnytime
Ready when you are

Your whole practice, one layer.

Built by a physician. Used by physicians. For physicians who'd rather be practicing medicine.

Apply for founding access