Listen
Start the visit and speak naturally. DocuMD separates speakers and captures clinical detail in context.
DocuMD turns the natural conversation into a structured clinical note, coding suggestions, and clear patient instructions—ready for you to review.
Live encounter
Physical therapy · 09:42
Dr. Patel
How has the shoulder felt since we changed your exercises?
Patient
Better overall. I still feel pain when I reach overhead, but it is down to a three.
Dr. Patel
Draft note
Patient reports improved right shoulder pain, now 3/10. Pain persists with overhead reaching.
Symptoms improving with current home exercise program. Overhead mobility remains limited.
Continue home program. Add resisted external rotation.
A quieter workflow
Documentation should follow the conversation—not control it. DocuMD keeps the workflow simple from first word to final review.
You stay in control. Every AI-generated note and suggestion is clearly presented for clinician review.
Start the visit and speak naturally. DocuMD separates speakers and captures clinical detail in context.
Choose the format your workflow needs—from SOAP and H&P to BIRP, DAP, and custom templates.
Edit the draft, resolve highlighted gaps, and review suggested ICD-10 and CPT codes before signing.
One conversation, connected outputs
Explore how one encounter becomes the documentation your team and patient need.
Structure
Turn the same conversation into a focused note with the sections, terminology, and level of detail your practice expects.
Subjective
Patient reports reduced resting pain. Pain persists with overhead reaching. Denies numbness or tingling.
Assessment
Right shoulder symptoms improving with current program; overhead mobility remains limited.
Plan
Continue home exercise program. Add resisted external rotation. Reassess next visit.
Example content is illustrative. All generated documentation and code suggestions require clinician review.
Your format, your voice
Start with a proven note structure or adapt a template to match the language, order, and detail your practice uses.
Everyday clinical encounters
Admissions and consults
Behavioral health sessions
Concise therapy documentation
Problem- or goal-focused care
Ongoing treatment updates
End-of-care documentation
Clear patient takeaways
Specialty-aware
Templates, terminology, and workflows shaped around the care you provide—not generic transcription.
Turn everyday visits into complete SOAP and progress notes with suggested ICD-10 and CPT codes.
Turn therapy conversations into structured BIRP, DAP, GIRP or SOAP notes while maintaining the therapist's preferred language and format.
Document medication management visits and psychiatric evaluations with structured, reviewable notes.
Handle complex, multi-problem visits with complete documentation and coding suggestions.
Document exams, injections and post-op visits with precise musculoskeletal terminology.
Capture evaluations, daily notes and progress reports while keeping your hands on the patient.
Documentation intelligence
DocuMD doesn’t just format the note. It helps surface missing details, suggested codes, and follow-up tasks so you can review the full picture in one place.
See where a required clinical detail may be absent.
Review suggested codes next to supporting documentation.
Pull medication, dose, and allergy details from the encounter.
Collect referrals, orders, and next steps in one place.
Pre-sign review
Duration not documented
Needs inputAdd total treatment time to support the procedure selection.
Add detailM25.511 suggested
SupportedRight shoulder pain is documented in the subjective and assessment.
Follow-up captured
ReadyReassess overhead mobility at the next scheduled visit.
Code suggestions are decision support, not billing advice. All AI-generated content must be reviewed and approved by the clinician.
Straightforward pricing
Explore the free experience, then upgrade when DocuMD becomes part of your day.
Try the workflow with short notes before you commit.
For clinicians who want DocuMD in their daily workflow.
Pricing shown in USD. AI-generated content and coding suggestions require clinician review.
Your next note can be easier