Pipeline Navigator
Hard Gate Execution Manual

New Patient Pipeline

This flowchart is our single source of truth. It is designed to eliminate dummy data, prevent ghost charts, and enforce 100% form completion.

Patient: Unknown HVA: Unknown
Step 01 Patient Action

New Pre-Intake Submission

System Visual Available Hover or Click to Pin
What the patient sees (Jotform) Click to Pin
Step 02 Automated

Bot Routing Matrix

IF INSURANCE
Target: Verification
IF SELF-PAY
Target: Step 03
System Alert Available Hover or Click to Pin
WHAT THE VERIFICATION TEAM SEES Click to Pin
K
Keragon Bot 1:04 PM
🚨 @VerificationTeam New Patient Pre-Intake Received!

Name:
DOB: 05/12/1988
Primary: Anthem BCBS
Member ID: YHJ123456789
📎 Front_Card.jpg
📎 Back_Card.jpg
Not Visible to HVAs
Hard Gate 1 Verification Team

Insurance Verification (Billing Team)

Terminate

Patient receives rejection protocol. No ghost chart is built.

Protocol Available
Coverage Denied Protocol Click to Pin
HUSHMAIL DECISION EMAIL

The team receives automated buttons and clicks:

Approve Hold Deny

Select Rejection Reason:

TERMINATE LEAD

Verified

Proceed Downstream

Protocol Available
Coverage Verified Protocol Click to Pin
STEP 1: HUSHMAIL DECISION EMAIL

The Verification Team receives automated buttons and clicks:

Approve Hold Deny
STEP 2: TEBRA COPAY ALERT (IF APPLICABLE)

If there is a known copay, inject a Patient Alert into Tebra before proceeding.

  • 1. Go to Account > Patient Alerts
  • 2. Enter: [ACTION REQUIRED] Collect ~$25 Copay
  • 3. Check boxes: Details, Scheduling, Encounters
  • 4. Click Save.
Proceed Downstream
Self-Pay Entry
Step 03 Automated

AFP Robot Execution

[BUILD] Tebra Shell Chart
[UPLOAD] Primary & Secondary Cards
[PING] #Intake-Ready in Chanty
View Logic Architecture Hover or Click to Pin
Keragon Engineering Map Click to Pin
Tebra: Create Patient Chart
Date & Time Helper
Upload Primary Cards
Branch: Has Secondary?
Upload Secondary
Safe Bypass
POST: Chanty Payload
Step 04 HVA Action

SEND TEBRA FORMS

Exact Checklist Available Hover or Click to Pin
Tebra Interface Simulator Click to Pin
TINA MATTHEWS-HAYES
Jane Doe
04/17/1992 (34 y/o) • (757) 513-3032
Basic Information Demographics [1-INTAKE 1] ALL...
Profile forms DO NOT CHECK
↳ Expand folder and pick sub-forms individually to avoid errors
Patient payment forms
Custom forms
Critical Logic
Pick Exactly 1 Based on Age
- OR -
Medical intake forms
Screening tools
Mandatory: Check Both
Step 05 HVA Action
[IF] Forms Dispatched
[THEN] Send SMS Primer
Exact Script Available Hover or Click to Pin
Tebra Messenger Protocol Click to Pin
tebra | New Message

Good news [Patient Name]! This is HVA from Alis Family Psychiatry.

I just got your insurance verified. I sent a quick link to your email and phone for your secure patient portal. As soon as you fill out the intake forms and drop a card on file using that link, I can officially secure your appointment slot. Let me know when that's done and I'll reach out right away with some date and time options! Let me know if you have any trouble finding the link.

Hard Gate 2: Pending Forms Hold HVA Action

Are Native Forms & CCOF Returned?

NO CCOF = NO APPOINTMENT

Calendar remains strictly locked until patient acts.

Follow-Up Protocol

Halt & Chase

24 Hours: Gentle Nudge
SMS / Email Script
"Hi [Patient Name], your chart is verified! Please complete your Tebra forms to unlock our calendar and schedule your intake."
72 Hours: Warn of File Pause
SMS / Email Script
"Hi [Patient Name], we are pausing your intake file. Once your forms are submitted, we will reactivate your profile for scheduling."
5 Days: Archive Lead

Verify Data Submission

PRE-FLIGHT AUDIT
Data Integrity Audit Click to Pin
1. HARD CCOF VERIFICATION

Do not blindly trust the "Form Submitted" status. Patients can bypass card entry.

Action: Go to Account > Collect Payment and verify a physical card is selectable.

2. DEMOGRAPHIC TYPO CHECK

Open the uploaded Driver's License and cross-reference it against the Tebra face-sheet.

3. DOCUMENT VERIFICATION & MERGE

Check the Documents tab to ensure the patient actually submitted the required forms.

Action: Go to Patient Intake and click Review to merge into chart.

Step 06 Final Execution

Finalize Scheduling

Scheduling Playbook

1. Provider Load Balancing

Check the calendar to see which provider has the most open slots. If you aren't completely sure who the patient should be routed to, click the Triage Matrix below.

Guide: Who to Schedule With
Script: Switch Providers Open App
2. The "Two-Option" Rule
  • NEVER ask "When are you free?" Hover
    Bad Script Example
    DO NOT USE

    "Hi [Patient Name],

    we got your forms. What day and time works best for you to come in?"

    Why it's bad: Surrenders control of the calendar
  • ALWAYS offer exactly 2 specific slots. Hover
    Good Script Example
    "HVA here again! [Patient Name], everything is set and we are ready to get you scheduled! Would Tuesday at work, or does Wednesday at work better for your 60-minute first appointment?"
    (Retains leverage & prevents typos)
3. Location Routing Protocol
Billing Guardrail

To prevent insurance claim rejections, you MUST select the correct Tebra Service Location when booking the slot:

  • Use [TELEHEALTH] for all Oregon and virtual visits.
  • Use [PHYSICAL] for Norfolk in-office visits.
Confirm Pre-Flight Audit (CCOF & Demographics) is complete.
Change patient Profile Status to Active.
Select correct Service Location [TELEHEALTH] vs [PHYSICAL].
Place verified patient on Schedule.
Reply in #Intake-Ready thread: ✅ Scheduled & Mapped