Tenant Management

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This area is available to tenant administrators and global administrators. What you see depends on your access level:

  • Global administrators can view all tenants, create new tenants, and enter any tenant’s context.
  • Tenant administrators can manage the settings of their own tenant from the settings gear menu (see Manage Tenant).

Accessing Tenant Management

As a global administrator:

From the left navigation, select Tenant Management. You will see a searchable table listing all tenants in the system.

As a tenant administrator:

Select the settings gear in the top navigation bar and choose Manage Tenant to go directly to your tenant’s detail page.

The Tenant List (Global Administrators)

The Tenant Management page displays a table with columns for Tenant Name, Description, and Status. You can search for a tenant by name using the search bar at the top of the table.

By default, the list shows active tenants only. Use the Show inactive toggle above the table to include tenants marked Inactive. Inactive tenants cannot log in and do not run background processing.

Each row includes two action icons:

  • Edit (pencil icon) — Opens the tenant’s detail page.
  • Enter Tenant (login icon) — Switches your session into that tenant’s context. You will be redirected to the Dashboard within that tenant. This option is visible to global administrators only.

Creating a New Tenant

  1. On the Tenant Management list page, select New Tenant in the upper right corner.
  2. A panel slides open on the right side. Fill in the required information and save.
  3. The new tenant will appear in the table.

Tenant Detail Tabs

When you open a tenant (either from the list or via Manage Tenant), you land on the tenant detail page with ten tabs: Tenant Details, Usage, Configurations, Guideline Evaluations, Communications, Integrations, Users, Business Units, Duplicate Patients, and Data Sources.

Tenant Details

The Tenant Details tab organizes core tenant settings into focused sub-tabs so you can jump to the area you need without scrolling through the full page:

  • Basic Information — Tenant Name, Status (editable by global administrators only), and Description. Global administrators can set tenant status to Active or Inactive. Inactive tenants cannot log in and do not run background processing.
  • Company Information — Corporate Name, Company Phone, Time Zone, Measurement System used for displaying observation values (for example, whether weight is shown in pounds or kilograms), and Company Logo. Upload a PNG, JPG, GIF, or SVG logo (max 5 MB) displayed at 100 px height with a 16:9 aspect ratio on outgoing letters. The same logo brands the header of your public prescriber portal; if no logo is uploaded, the portal shows the tenant name instead. Upload or delete failures show an in-app error notification. Deleting the logo asks for confirmation in a dialog before the logo is removed.
  • Company Address — Address lines, city, state, and zip.
  • Primary Contact — Contact name, phone, and email.
  • Public Portal — Public Portal Slug, the short name that appears in this account’s public prescriber portal address (/p/your-slug). Use lowercase letters, numbers, and hyphens only, up to 63 characters. Leave it blank to keep the public portal turned off. Each slug can belong to only one account — if you enter one that is already taken, saving fails and you are asked to choose another. When a slug is set, select Open public portal below the slug field to open the live portal in a new tab.

After making changes on any sub-tab, select Update Tenant (or Create Tenant when you are adding a new one). After Update Tenant, you stay on that tenant’s detail page and a confirmation appears — including when a global administrator opened the tenant from the list. After Create Tenant, you return to the tenant list.

Usage

The Usage tab shows month-to-date AI spend against the monthly allowance, historical AI spending, raw token and BDA activity, and fax activity for the last 3 months. Tenant administrators can view this information but cannot change the allowance. Select Refresh in the upper right to pull the latest figures.

  • Current AI budget — Under This month, Used this month is the headline figure: AI spend so far in the UTC month shown against the monthly allowance, such as “$12.40 of $100.00”. When the tenant has no allowance set, the card shows the amount spent on its own. Remaining this month shows what is left of the allowance, alongside how much time is left in the UTC month. Tenant administrators see these two cards and the historical and raw usage sections below.
  • Short-term pacing — This group requires global administrator access. Pacing bucket shows how full the short-term pacing allotment is against its capacity. This allotment refills continuously and is not the monthly budget; it only controls how quickly background AI work is admitted. Room or overfill shows the headroom left in that allotment, turning amber when it is overfilled, and Drains at shows how fast it refills per day. Next background AI admission tells you when background work can start again; when the wait would run past the end of the UTC month it reads After the monthly reset, with the time left until that reset underneath, because month-to-date spend clears at the month boundary and admission is re-evaluated then. Deferred background AI gives the number of waiting jobs and the oldest wait. Estimated backlog clearance estimates how long clearing them will take, based on priced-job history; when that estimate would run past the end of the UTC month it reads After the monthly reset, with the time left until that reset underneath, because month-to-date spend clears at the month boundary and clearance is re-evaluated then. A warning appears when the estimated backlog will not clear before month end. When live pacing figures are unavailable, global administrators see a notice on this group while month-to-date spend and historical usage stay visible to everyone.
  • Historical AI passthrough spend — Shows the priced dollar total with breakdowns by feature, model, and month. Notices identify estimated pricing, fallback pricing, and legacy or unpriced records. Unpriced jobs are excluded from the dollar total.
  • LLM usage — Cards at the top show total input tokens, total output tokens, and the number of AI jobs run. Below the cards, one table breaks the same figures down by feature (which part of the product ran the job) and another breaks them down by model. A third table shows the month-by-month trend. If the tenant has not run any AI jobs yet, this section says so instead of showing empty tables.
  • BDA OCR — Appears when Bedrock Data Automation is turned on for this tenant in Configurations → Document Extraction Settings, or when the tenant has recorded BDA activity in the window. It shows the number of invocations and the number of pages processed, plus a month-by-month breakdown when data is available.
  • Fax — A table with one row for inbound and one for outbound, listing the number of pages and the number of faxes in each direction.

Configurations

The Configurations tab organizes workflow and policy settings into focused sub-tabs so you can jump to the area you need without scrolling through the full page:

  • Workflow & Appeals — PA Workflow Settings (staff review before determination communications, pharmacy fax contact, and for global administrators Determination LLM summary) and Appeals Settings.
  • Guidelines — Guideline review period, and (for Ethicos administrators) guideline library adoption, evidence checks, and Describe Rules. AI guideline authoring appears here for both tenant administrators and Ethicos administrators; only an Ethicos administrator can change it.
  • Data Requests — Data Request Configuration (expiration, follow-up timing, and CC destination).
  • Data Warehouse — Data Warehouse Delivery, which sends your reporting extract to your own SFTP server once a day.
  • Document Extraction — Visible only to global administrators. Contains Use Bedrock Data Automation (BDA).

Tenant administrators and global administrators both use this tab for the settings they are allowed to change.

Fax pharmacy on PA determinations in PA Workflow Settings also decides whether pharmacies receive exclusion notices. When it is on, the pharmacy receives the excluded medication letter along with the prescriber, and Pharmacy Contact Mode sets whether that letter goes automatically or is held for staff. A formulary or an individual exclusion can override it.

Data Request Configuration (on the Data Requests sub-tab) controls how open data requests expire, when automatic follow-ups are sent, and whether CC copies are sent on later send attempts:

  • Expiration (days) — How long open data request tasks stay active before they expire. Leave blank to use the default of 14 days. Individual guideline settings can override this tenant default.
  • First follow-up (days) — Days after the initial send before the first automatic follow-up fax or email. Leave blank to use the default of 3 days. Applies to data requests and remediation requests.
  • Second follow-up (days) — Days after the initial send before the second automatic follow-up. Leave blank to use the default of 7 days. If you set only one follow-up field, the blank side uses its default (3 or 7 days); the effective pair must keep the second value greater than the first. Applies to data requests and remediation requests.

Open automatic data requests and remediation requests already in progress pick up new follow-up timing at the next reminder run (when the system evaluates whether a follow-up is due), not retroactively on every past send.

  • CC recipient type and destination — Choose Fax, NPI, or Email, then enter the CC destination (fax number, provider NPI, or email address). Leave the destination empty if you do not want CC copies.
  • CC recipient display name — Optional label shown on data-request CC fax covers and in Communications Outbox. It only applies when a CC destination is configured above. You must enter a destination before you can save a display name.
  • Send CC on attempt — When a CC destination is set, choose whether the CC copy is created on the second or third data-request send attempt.

Select Save after changing Data Request Configuration settings.

On the Guidelines sub-tab, use Guideline review period to set the tenant’s default number of days after a guideline’s last evidence check before the next check is scheduled. Enter a positive whole number, or leave it blank to use the system default of 365 days.

Reporting Tags sits below Guideline Settings. Use it to maintain the shared list of tags your team can assign to guidelines (for example, therapeutic areas you may group in reports later). Managed tags appear as chips:

  • Enter a name in New tag and select Add tag to add it to the catalog.
  • Select a chip to rename it. Renaming updates every guideline in your account that uses that tag and updates the catalog entry.
  • Select the close icon on a chip to remove the tag from the catalog and from every guideline that uses it. Confirm before the removal runs.

If guidelines already use tags that are not in the catalog, they appear under Tags in use but not in catalog. Select Add to catalog on a tag to add it to the managed list without changing guideline assignments. Tag names are compared without regard to letter case, so you cannot add two catalog entries that differ only by capitalization.

Enable guideline library adoption, Enable guideline evidence checks, and Enable Describe Rules (AI rule generation) are visible and editable only by Ethicos administrators. Tenant administrators do not see those toggles; they can still view and save the guideline review period and other configuration settings on this tab.

AI guideline authoring is off until an Ethicos administrator turns it on. It appears in Guideline Settings for tenant administrators and Ethicos administrators. It controls whether this account can create AI-authored guidelines and regenerate a guideline document after its rules change. Tenant administrators can see the current setting but cannot change it — only an Ethicos administrator can turn it on or off. When it is off, the AI Authored Guideline card in the new-guideline flow is unavailable and Regenerate document actions for guidelines are disabled.

Enable Describe Rules (AI rule generation) is off by default. When it is off, the Describe tab in rule builders appears greyed out and Generate Rules is disabled for this tenant. The Builder and JSON tabs keep working. Turn the toggle on to let users generate rules from a plain-language description.

AI Passthrough Budget appears on Guidelines and is visible and editable only by global administrators. Enter a monthly US-dollar allowance to pace background AI work. Leave the field blank for unlimited background AI, or enter 0 to stop background AI while interactive work continues. Select Save AI passthrough budget to apply only this setting.

Determination LLM summary (on Workflow & Appeals) and Use Bedrock Data Automation (BDA) (on Document Extraction) are visible and editable only by global administrators. Tenant administrators do not see these toggles. When Determination LLM summary is on, PA timelines show an AI-generated summary banner above Determination Review; when off, staff still use Determination Review without the summary text.

Data Warehouse Delivery (on the Data Warehouse sub-tab) sends your plan’s own reporting extract to an SFTP server you control. What is delivered:

  • Your plan’s own reporting extract, delivered as one file, once a day, from the latest reporting snapshot.
  • The clinical and operational collections used for reporting.
  • It does not include the user file or any other plan’s data.

The delivery goes to its own folder. It is separate from letter printing, so it never shares a folder with your Letter Delivery services.

Delivery is off until you turn it on. Fill in the form, then select Save warehouse delivery. This sub-tab has its own save button, and no other Save on the page changes it.

  • Enable warehouse delivery — turn this on when the connection is ready. To turn it on you need a host, a username, a remote folder, and either an SSH private key or a password.
  • Host, Port, and Username — where GEMA connects and who it signs in as. Port is 22 unless you change it.
  • Remote folder — where the daily file is placed. It starts as /warehouse. If it points to the same server, port, username, and folder as one of your Letter Delivery services, saving is refused with a message asking you to choose a different folder.
  • SSH private key (PEM) — the preferred way to authenticate. Paste the full PEM block, including the BEGIN and END lines.
  • Password (fallback) — for servers that do not accept SSH keys.
  • Host key fingerprint (recommended) — the SHA256 fingerprint your server administrator provides, so GEMA can verify the server before sending your data. A warning shows while it is blank.

Once a key or password is stored, the fields stay blank and a note tells you it is already stored. Leave a field blank to keep the stored value; type a new value only to replace it.

To encrypt the file, turn on Encrypt the file with PGP and paste your own public key into Your PGP public key. Paste the whole block, from the BEGIN PGP PUBLIC KEY BLOCK line to the END line. The public key is not a secret, so it stays visible after you save. You keep the matching private key, GEMA never asks for it, and you need it to open the file. Clear the box and save to remove the key. If you paste a private key, or turn encryption on without a public key, saving is refused and the message explains why.

Guideline Evaluations

The Guideline Evaluations tab lists batch guideline evaluations for this tenant — pending, running, completed, and failed runs. Select any row to open the evaluation detail page and review patient results. Users who can edit guidelines but are not tenant or global administrators open the same list from the Settings gear menu instead. See Running Guideline Evaluations for triggering runs and reading outcomes.

Communications

The Communications tab organizes letter and guideline communication settings into focused sub-tabs:

  • Letter Signer — name, credentials, and title that appear on patient letters. Select Save after editing.
  • Letter Delivery — shared delivery services used to send letter PDFs. Select Add Service to choose a delivery type — SFTP is available today; Mail is listed as coming soon. Each letter template set to SFTP picks a connection by name. If you disable or remove a connection that enabled letter templates still use, a confirmation lists those templates before the change is saved.
  • Letter Templates — enable and configure each letter type and recipient.
  • Guideline Communications — a read-only dashboard of every guideline’s contact modes (prescriber, patient, pharmacy) and letter enablement, including whether each value comes from the guideline, a formulary, the tenant, or the policy default. Expand a row to see each letter’s on/off state and source. Select a guideline title to open that guideline and edit its settings. If you opened this tenant from Tenant Management without entering its context, enter the tenant first so the dashboard loads for that tenant’s session.
  • Send Pending Letters — preview or immediately deliver queued letters (normally sent daily at 03:00 UTC). If you opened this tenant from Tenant Management without entering its context, enter the tenant first so send actions run in that tenant’s session.

See Communication Letters for signer fields, delivery options, templates, and batch send.

Integrations

The Integrations tab organizes external connections into focused sub-tabs: Fax, PharmPix, GPG Key, and (when available) Partner API Keys. See the Integrations article for details.

Users

The Users tab lists everyone with access to this tenant. From here you can invite new users, assign roles, and manage existing accounts. See Users and Roles for full instructions.

Business Units

The Business Units tab shows the organizational hierarchy for this tenant. You can create, rename, and rearrange business units here. See Business Units for details.

Duplicate Patients

The Duplicate Patients tab surfaces patient records the system has flagged as possible duplicates within this tenant. Administrators can review the flagged pairs and merge records where appropriate.

Data Sources

The Data Sources tab lists the reports that power dashboard widgets for the tenant you are signed into. Create AI-generated reports, clone Report Library templates, and open a data source to preview it. Data sources follow your signed-in tenant — if you are viewing another tenant from Tenant Management, select Enter Tenant first, then open this tab. See Data Sources for details.