HVA Decision Tree for New Patient Intakes (Updated per Clinical Leadership)
Trigger
Scheduling Request
Jotform scheduling payload arrives in Chanty with demographics and clinical history.
Decision Gate 1
Check Reason for Visit
[Psychiatric Red Flags Detected]
High Psychiatric Complexity
Unstable Bipolar, Schizophrenia, Acutely Manic or Psychotic.
Unstable vs. Stable (Keyword Guide):Unstable (Route to Tina): Jotform mentions "Recent hospitalization", "Crisis", "Manic", or "Hallucinations". Stable (Route to Elizabeth): Jotform mentions "Routine refill", "Maintenance", or "Stable on meds".
If Unstable: Route to Tina
If Stable: Jump to Gate 2
Tina requires PNP Credential
[Routine or Medical Complexity]
Decision Gate 2
Payer Type & Provider Preference?
[Sentara / Tricare / Cash Pay]orNo Pref
Auto-Route to Elizabeth
Send standard 2-option SMS to lock in Elizabeth's schedule.
[Anthem or Specifically named Tina]
Script Trigger
Execute "Exclusive Favor" Waterfall Script
"Hi , we just got your paperwork and you are completely cleared to schedule! Tina's intake schedule is currently full and booking out into late next month.
However, to help you skip the wait, Nurse Practitioner Elizabeth Hayes, who works directly with Tina, actually just opened up a priority block on her calendar for us! We can sneak you in to get you seen much sooner.
Should I go ahead and lock in the
at
slot for you, or does
at
work better?"
Time Selection Rules (Preventing Gaps)
Rule 1: Back-to-Back (No Gaps)
Stack appointments back-to-back. 🚫 NO 30-min gaps.
Rule 2: 1 Morning + 1 Afternoon
Offer exactly: 1 Morning + 1 Afternoon.
e.g., "Tuesday at 9:00 AM or Thursday at 3:00 PM"
Rule 3: Earliest Dates First
Pitch the absolute earliest open dates first. 🚫 Never skip an open day.
Edge Case & Objection Handling
1. The "Ghost" (No Reply after 24hrs)
"Hi [Name], just checking in! I need to release these priority slots to our waitlist by 5:00 PM today, but I wanted to check with you first. Did you want me to keep [Time] secured for you, or should I go ahead and release it?"
2. Schedule Clash (Wants Elizabeth, bad times)
"Not a problem! Elizabeth's evening and Friday slots are usually the first to go, but I can actually unlock a reserved block for you. Does Thursday at 6:00 PM or Friday at 9:00 AM fit your schedule better?"
3. The Form Complaint ("Why is Tina an option if she's not available?")
"Great question! We keep her as an option because Tina is our Medical Director and takes our most severe clinical escalations. For routine care, we prioritize getting our patients seen immediately with Elizabeth so you don't have to wait months for relief!"
4. The Loyalist (Explicitly refuses Elizabeth)
"I completely understand! Tina is booked solid right now, but we actually just had a cancellation pop up. Because I have you on the line, I can grab it for you right now before it goes to the waitlist. Should I lock in [Morning Time] or [Afternoon Time]?"
5. The Friday Pivot (Patient asks for a Friday)
"Tina actually only sees patients Monday through Thursday. But because Friday appointments are always in such high demand, Nurse Practitioner Elizabeth runs a special end-of-week clinic so our patients don't have to wait! I can go ahead and grab a spot for you with her for this week. Would Friday at 9:00 AM or 1:00 PM work better?"
Banned Actions (The No-Nos)
1. Saying "Lizzy" or "Daughter"
Never use nicknames or mention family ties. This strips away clinical authority. Always use "Nurse Practitioner Elizabeth Hayes."
2. Offering Future Transfers to Tina
Never tell a patient they can see Tina for follow-ups later. The goal is to establish them with Elizabeth permanently to protect Tina's calendar.
3. Weak "Yes/No" Closes
Never ask "Would you like to move forward?" Always use the Double-Bind close to force a choice between Time A and Time B.