For hospitals and health systems
A voice at the bedside, and the picture after discharge.
Patients who cannot speak tap a phrase and the tablet says it out loud. When they go home, the family and the home team log meals, medications, vitals, glucose and falls every day, and your clinicians read it on one panel with alerts against your own targets.
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Running a cancer center? See the cancer center page.
Running a discharge or transitional care program? See the discharge program page.
The gap
The patient cannot speak in the bed. At home, the picture stops.
Speech lost at the bedside
After a stroke, or with a breathing tube, a patient who can think and understand cannot answer the nurse, ask a question or say where it hurts.
Discharge instructions go home on paper
The medication list, the targets and the when-to-call instructions leave in a folder. Whether anyone at home follows them is hard to see.
The 30 days after discharge are a blind spot
What happens at home in those weeks reaches you only if someone calls or comes back. Medicare's Hospital Readmissions Reduction Program lowers payments to hospitals with more readmissions than expected, by up to 3%.
The family calls the unit
Questions, worries and "is this normal?" reach the unit by phone after discharge, one call at a time, with nothing written down.
At the bedside
A voice for patients who cannot speak, on a tablet at the bed.
ExpressAgain runs in the web browser on a phone, tablet or computer; there is nothing to install. This is what exists today for a patient who can think and understand but cannot reliably speak.
Tap to speak
One tap on a phrase says it out loud. Quick Speak tiles hold what is needed most, a Letters board spells a word, and a Type tab speaks anything typed. A 3 at a time switch shows fewer choices on hard days, and there is no timer.
Tap any phrase to speak it →The sentence builder
Starters like I am, What about and Let's open lists of real things a patient in that bed wants to say, so a sentence comes together piece by piece.
Build a message →The Medical Words dictionary
What an MRI is, why doctors use saline, what to expect, in plain language, with questions the patient can tap to ask your team out loud. It explains words, never the patient's own case.
Medical Words →Emergency phrases
Emergency phrases spoken with one tap, pain and where it hurts, and the SOS card on every page with a rail: I need help now. Please come now. This is an emergency.
The Emergency page and SOS →The patient's own voice
A short recording becomes a cloned voice that sounds like the patient. Until it is ready, a clear built-in voice speaks, so the patient is never without one.
Speaking in the patient's own cloned voice →The Aphasia and Stroke mode
The condition mode with its library fully built. The core library, the Learn courses about stroke and aphasia, and Practice Out Loud were built for this patient first: someone who can think, read and understand but cannot get the words out.
ExpressAgain for aphasia and stroke →
For ICU and a breathing tube: the ICU mode is live, with its own phrase library for breathing and the tube, calling the nurse, pain from 0 to 10, yes and no, and after surgery, alongside the Communicate page with big tiles, the Medical Words dictionary and the emergency phrases. ICU and a breathing tube.
Every condition we support, and what is built for each.
See it on a tablet, the way a patient on your unit would.
Request a demo
Give patients who cannot speak a voice at the bedside
See tap-to-speak, the sentence builder, the Medical Words dictionary and the emergency phrases on a tablet, the way a patient on your unit would use them.
Rather pick a time now? Book a 30-minute demo.
After discharge
The first weeks at home, in one place your clinicians can read.
Enroll the patient at discharge by email or text; the family accepts, and the patient appears on your organization's panel. Then the family and the home team log meals, the medications given or missed and by whom, vitals and glucose, the bathroom, sleep and falls, and your clinicians read it against the targets your team set.
Loretta Banks, 78 · Sample Regional Hospital
Type 2 diabetes · hypertension · the first week at home after discharge
| This week | Mon | Tue | Wed | Thu | Fri | Sat | Sun |
|---|---|---|---|---|---|---|---|
| Glucose, fasting | 118 | 124 | 115 | 131 | 120 | 126 | 117 |
| Glucose, after dinner | 142 | 214 above target | 150 | 228 above target | 138 | 205 above target | 146 |
| Blood pressure, morning | 132/78 | 128/76 | 136/80 | 130/78 | 134/82 | 129/77 | 131/79 |
| Meals logged | 3 · 1,610 cal | 3 · 1,720 cal | 2 · 1,240 cal | 3 · 1,800 cal | 3 · 1,580 cal | 3 · 1,760 cal | 3 · 1,540 cal |
| Evening medications | Given | Missed | Given | Missed | Given | Given | Missed |
| Urination, times | 7 | 7 | 6 | 6 | 5 | 4 | 4 |
| Bowel movements | 1 | 0 | 1 | 1 | 0 | 1 | 0 |
| Sleep and naps | 7.5 h | 6 h + nap | 7 h | 6.5 h | 7 h | 6 h + nap | 7 h |
| Symptoms and falls | None | None | None | None | None | Dizzy spell, 3:40 PM | None |
| Personal care, moving | Shower · steady | Steady | Wash-up · steady | Steady | Steady | Wash-up · weak | Steady |
Every entry in the app carries who logged it and when, for example Given 7:05 PM by Anita (Home health). Readings are typed by the family and the home team.
What you can see, and ask about
Glucose runs high after late dinners
The three readings above 180 all came after dinners at 8:30 PM or later. On the early-dinner days the readings stayed between 138 and 150.
Ask: What changes on the late-dinner days, and who is cooking?
Three missed evening doses this week
Tuesday, Thursday and Sunday: each entry shows who logged it. Two of them fell on late-dinner days.
Ask: Who is in the home at 7 PM on those days?
Fewer bathroom trips and a new dizzy spell
Urination went from 7 a day to 4 by the weekend, and Saturday brings a dizzy spell and a weak wash-up.
Ask: Is the patient drinking enough? Anything new on the medication list?
Sample data: an invented patient and invented numbers. ExpressAgain shows the entries and whether each reading is inside the targets your team set; reading the week and asking the questions is the clinician's work. The app does not diagnose or draw conclusions.
See it with one of your own discharges in mind.
Request a demo
Hand off to the family at discharge and see the 30 days at home
Walk through enrolling a patient at discharge, the family's home log, care alerts against your targets and the reports your team reads in the weeks after.
Rather pick a time now? Book a 30-minute demo.
What your hospital gets
From the bed to the weeks at home, working for your hospital.
All of it is live today, except where a line says it is waiting on a vendor or on activation.
Bedside communication
Tap-to-speak, the sentence builder, the Medical Words dictionary and the emergency phrases, in the web browser on a tablet or phone at the bed. Communicating is never behind a paywall for the patient.
Tap any phrase to speak it →Enrolling a patient at discharge
Enroll a patient by email or text; the message names your organization, never the patient, and the family accepts. Add covering colleagues, staff or a coordinator, resend while it waits, or end it, which revokes every access.
Enrolling patients and coverage →The organization panel
Every enrolled patient on one screen: last reading, open alerts and how old they are, unread feed and enrollment status. Tap a row to open that patient's whole dashboard. Coverage by provider and staff, and an escalation window in minutes, set in Settings.
The organization panel →Care alerts against your targets
Your team gives the family its ranges and when-to-call instructions. Every reading becomes one plain line for your clinicians, and a reading outside the targets goes out at once. The rule is your numbers; it is not a diagnosis.
Targets and care alerts →The family's home log
Glucose, blood pressure and pulse, weight, temperature, oxygen, meals, medications given, skipped or refused with who and when, bathroom, sleep, symptoms including falls and swelling, personal care and how the patient moved.
Health Tracking →Health reports and the weekly summary
Vitals and glucose, medications, symptoms and alerts, the visit flow sheet, and a weekly home summary. 7, 30 or 90 days, Print and CSV, the same report the family reads.
Health reports →Appointments for the follow-up visit
The follow-up visit with where to go, what to bring, who is driving and who goes along. It is on the patient's schedule and your care dashboard the moment it is booked, and the family writes down what happened.
Appointments →The contacts log and billing support
Calls, video, office and home visits, caregiver training and the discharge date, with the day, time, minutes and who was involved. For your physician groups, the monthly report runs the transitional care checks: the discharge on record, the interactive contact within 2 business days, the visit within 7 or 14 days. It never picks a code.
Billing support →Insurance & Devices
Primary and secondary coverage with member IDs sealed, and the home monitors on file with who provided them. The billing report shows the payer and plan, never a member ID.
Insurance & Devices →The Partner API and HL7
The Partner API reads what families shared with your organization and pushes readings and documents back, with every call logged; keys are issued after a signed BAA. The HL7 v2 feed is built and pending activation.
Partner API documentation →Chart connections: Epic and eClinicalWorks
Read-only connections, authorized by the patient or their proxy, are built. Each one activates as the vendor approves the app; until then the weekly home summary prints and shares as a PDF.
Doctor's Records →Packages and onboarding
Start with a six-month departmental pilot in one unit or service line, then grow into a department license, a hospital-wide license or a health-system agreement. Integration is scoped per agreement.
How onboarding works →
Potential reimbursement
See your physician groups' potential.
Chronic care, principal care and transitional care management are billed by physicians and qualified practitioners under the Medicare Physician Fee Schedule, so this estimate is for your employed and affiliated physician groups. Hospital outpatient departments bill care management under the outpatient payment system, which pays differently, and this estimate does not cover it.
Estimated reimbursement opportunity
$1,524a month
$18,284a year
- Enrolled Medicare patients
- 36
- TCM episodes a month
- 2
- Allowed reference a month
- $2,381
Not in the dollars yet: 99495. Rate varies: load your payer rates in the app. The estimate above counts only codes with a verified or CMS-loaded national rate, so it is on the low side.
Estimated reimbursement opportunity. National Medicare non-facility rates; your MAC locality, payer mix, coinsurance and documentation determine what is paid. Eligibility, coverage, coding and payment remain subject to payer rules and claim adjudication.
The breakdown
Chronic care management (CCM), clinical staff time
In the total36 enrolled Medicare patients · 99490 × 36 at $66.13
- Allowed reference
- $2,381 / mo
- Medicare pays 80%
- $1,905 / mo
- Estimated
- $1,524 / mo · $18,284 / yr
20 minutes for the first code, each further 20 minutes an add-on unit. Two or more chronic conditions, consent, a care plan.
Complex CCM
Comparison only36 enrolled Medicare patients
Not at this many minutes
Needs 60 minutes or more of clinical staff time a month and moderate or high complexity decision making.
Principal care management (PCM)
Comparison only36 enrolled Medicare patients
Not at this many minutes
Needs 30 minutes or more of clinical staff time a month, for one serious chronic condition.
Transitional care management (TCM)
In the total2 discharges a month · 99495 × 2
Rate varies: load your payer rates in the app
Contact within 2 business days and a visit within 14 days of discharge (99495); a visit within 7 days with high complexity is 99496. CMS allows CCM during the TCM period (MLN909188).
How it is worked out
- 200 patients with two or more chronic conditions × 30% who enroll × 60% on Medicare = 36 enrolled Medicare patients.
- At 20 minutes of clinical staff time a month, each reaches 99490 for CCM.
- 4 discharges a month × 60% on Medicare = 2 TCM episodes a month (99495, the 14-day level).
- Units × the national non-facility allowed amount = the allowed reference. Medicare pays 80% of it (the patient owes the 20% coinsurance after the Part B deductible), × 0.8, the "likely" planning assumption the app's billing reports use = the estimated reimbursement opportunity. Yearly = monthly × 12.
- The total counts CCM plus TCM. Complex CCM and PCM are shown for comparison: a patient gets one of them instead of CCM in a month. A code without a verified or CMS-loaded rate adds nothing to the dollars.
Where the rates come from
CY 2026 Medicare Physician Fee Schedule, national non-facility amounts (MAC locality 0000000). 99490 was checked against the CMS PFS dataset on 2026-09-27: 1.98 total RVUs × the $33.4009 conversion factor = $66.13. Codes without a verified rate show that the rate varies until the CMS rows are loaded.
Medicare's national non-facility reference; your MAC's locality differs — verify with your biller.
Code numbers are shown; every description here is ExpressAgain's own plain wording. CPT is AMA-licensed content and its descriptors are not reproduced.
Readings in ExpressAgain are typed by people, so remote physiologic monitoring is not part of this estimate.
We will run it with your physician groups' own numbers.
Request a demo
Capture the care management your physician groups provide
Walk through the monthly billing support report for your employed and affiliated physician groups: the time clinical staff logs, the contacts, consent and the estimated reimbursement opportunity it documents.
Rather pick a time now? Book a 30-minute demo.
What clinicians say
From the pilot practice.
These are clinicians at the physician practice piloting ExpressAgain.
This is very helpful.
This is all in one. Convenience is everything, and this is super convenient.
Why we built it
I built ExpressAgain for my mother, Debbie. Five lesions on the left side of her brain took her speech, not her mind. She still has so much to say — now she has the tools to say it.
How onboarding works
From a demo to your first patient enrolled at discharge.
A 30-minute demo
We walk through the bedside tools, enrolling a patient at discharge, the home log and the billing support report, and run the calculator with your physician groups' numbers.
Scope a six-month departmental pilot
Pick one unit or service line and agree the patient capacity and scope together, then sign the agreement. We sign a Business Associate Agreement with partner organizations once our vendor agreements are complete; that is in progress now, so ask us for the timeline.
We set up your organization and train the unit
Our team creates your organization and sends your first admin an invitation to sign in. We train the unit; your admin invites its clinicians, and the unit enrolls patients at discharge by email or text.
Grow from the pilot
From the pilot into a department license, a hospital-wide license or a health-system agreement across several hospitals and departments.
Ways to work with us
Departmental Pilot
Six months in one department or service line, with the patient capacity and scope agreed together.
Department License
The department keeps going after the pilot, under its own license.
Hospital Enterprise License
Every department in the hospital, under one license.
Health System Agreement
Several hospitals and departments under one agreement.
Integration
EHR, HL7, FHIR, single sign-on or custom work, scoped per agreement.
Hospital pricing is set with each hospital in the demo; it is not published.
Questions
What hospitals ask us.
Give patients a voice at the bedside and see the weeks at home. Start with a 30-minute demo.
Pick a time that suits you, or tell us what you need and we will reach out.
Request a demo
Talk to us
Tell us about your hospital or health system and what you are trying to solve. A real person replies within one business day.
Rather pick a time now? Book a 30-minute demo.
One team, one plan
Built for the interdisciplinary care team
ExpressAgain is an integrated patient care, communication, and care management platform built for people who can think, read and remember clearly but struggle to speak, as well as people who can speak for themselves but have no safe, trusted way to show whether the care they're receiving is the care they're owed.
As an all-in-one platform, it brings patients together with the families, caregivers, nurses, therapists, physicians and agencies who care for them, so everyone works from one plan, one schedule and one shared record, from the hospital to home.
The same day, the same medications, the same notes, and the same record of who did what and when.
The patient is in the middle, and six kinds of people care for that one person. Every arrow runs between a box and the patient, and the ring runs through all six:
- Families: the daughter, the siblings, the friends who show up.
- Caregivers: aides, CNAs and companions in the home, hired directly or sent by an agency.
- Nurses: RNs and LPNs on visits, shifts and medications, with the visit note.
- Therapists: speech, physical and occupational, with exercises to practice at home.
- Physicians: MDs, DOs, NPs and PAs, reading what changed since the last visit.
- Agencies: the office that staffs, schedules and bills.
All of them work from one plan, one schedule and one shared record: the day plan the family writes is the one the aide follows and every care-team login reads.
Hospice, palliative care and community paramedic clinicians join the care team the same way, with a code from the family.