Head-to-Head Architecture Comparison
When REI clinicians evaluate documentation systems, the bottleneck is rarely the quality of the prose. It is whether cycle day, follicle diameters, endometrial thickness, and prior failed cycles reach the correct Practice Fusion field before the next monitoring patient is roomed. On a morning with 30 scans, a 60-second copy-paste step per note costs half an hour.
Heidi Health is a capable general-purpose ambient scribe. It offers a free tier and a Pro plan listed at $99 per month, billed monthly, at the time of this review. Its notes are well structured. For Practice Fusion users, however, the published workflow ends with a copy action, and the clinician moves text into Subjective, Objective, Assessment, and Plan by hand. Merry AI's Chrome extension writes directly into those SOAP fields.
| Feature | Merry AI | Heidi Health |
|---|---|---|
| Real pricing | Pro Annual $54/mo ($648/yr), flat | Free tier; Pro $99/mo list ($1,188/yr) |
| Practice Fusion DOM injection speed | Direct write to SOAP fields, under 2 seconds | Copy-paste by section, about 45-90 seconds (internal timing) |
| REI cycle schema | Discrete cycle day, per-ovary follicle grid, endometrial thickness, cycle ledger | Free text or custom template |
| Group note-splitting | Couple consults split into two linked charts | One note per session by default |
| CPT G2211 capture | Rule-based; suppressed when modifier 25 is procedure-driven | No published G2211 logic |
| Attestation logging | Timestamped REI focal-point attestation block | Entered manually by the clinician |
| Data retention | Audio held in RAM only, shredded at zero days | Set by vendor configuration; review the BAA |
Practice Fusion SOAP Field Binding in Chrome
The extension reads the active Practice Fusion encounter page and identifies the Subjective, Objective, Assessment, and Plan inputs by their DOM attributes. It writes only after the clinician approves the draft. Fields are routed as follows:
- Subjective: cycle day and prior failed cycles.
- Objective: follicle counts per ovary, leading follicle diameters, and endometrial thickness.
- Assessment: stimulation response.
- Plan: trigger timing, IUI or retrieval plans, and the attestation.
No field is overwritten without a visible diff, so the clinician sees every change before it is saved.
REI Cycle Documentation Integrity
Infertility care is longitudinal by nature. A patient starting her third letrozole-IUI cycle after two failed attempts carries a history that justifies today's protocol change. That history must be clear to a reviewer who has never met her. Merry AI keeps a compact cycle ledger that records cycle type, protocol, peak follicle response, outcome, and failure point (poor response, fertilization failure, or implantation failure).
Follicle Grids and Cycle-Day Logging
Ultrasound narration such as 'right ovary, three follicles at 14, 16, and 18.5 millimeters' is parsed into a per-ovary grid stamped with the cycle day. Because the values are stored as discrete data rather than buried in prose, response curves and cancellation or OHSS thresholds can be compared across visits. Heidi Health can approximate this with a custom template, but the output remains narrative text that the clinician must transfer manually.
Couple consultations add a second patient to the room. Merry AI's speaker diarization separates the partner's speech, so semen analysis findings and male-factor history go into a linked note in the partner's chart. They are not embedded in the female patient's record.
CPT G2211 and Modifier 25 Logic
CMS defines G2211 as visit complexity inherent to care that serves as the continuing focal point for a serious or complex condition. In 2026 it can be added to office/outpatient E/M codes (99202-99215) and to home or residence E/M codes. The constraint that matters most in REI is modifier 25. CMS denies G2211 when the E/M carries modifier 25 because of a same-day minor procedure, such as IUI (CPT 58322). The exception covers only annual wellness visits, vaccine administration, and other Part B preventive services.
The arithmetic is straightforward but conditional. At an approximate national allowable of about $16 per unit, $15,600 in annual recovery requires roughly 975 qualifying encounters. That is about four per clinic day across a 245-day year. The figure applies only to payers that recognize G2211. Medicare volume in REI is modest, so practices should model their own payer mix before forecasting.
The Clinical Logic Bridge Attestation
Each qualifying visit receives a timestamped attestation that names the chronic infertility diagnosis, the coordination work (endocrinology, genetics, counseling), and the REI specialist's focal-point role. When charge capture shows a procedure-driven modifier 25, Merry AI suppresses G2211 and logs the reason. Modifier 59 is never proposed on an E/M line. For the underlying literature, peer-reviewed sources are searchable at https://www.ncbi.nlm.nih.gov/pmc/, and CMS publishes a G2211 FAQ.
Cost, Retention, and Next Steps
At list prices, the gap is $540 per clinician per year: $1,188 for Heidi Health Pro billed monthly versus $648 for Merry AI Pro Annual, a 45% reduction. A four-physician REI group saves $2,160 a year before counting any time or coding effects. Heidi's free tier lowers the entry cost. We compare paid tiers because a full production monitoring schedule typically requires one.
Audio is held only in RAM during transcription and is shredded at zero days once the note is written to the chart. No stored audio exists to be subpoenaed or breached. State statutes on AI and recording vary, so consent prompts and retention policies are configurable by state. Practices should confirm their requirements with counsel.
If you would like to review your own cycle-monitoring notes against this framework, Schedule a 15-Minute Workflow Audit. We will walk through one de-identified encounter, field by field.
