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Fictional healthcare template

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Your three-location referral path asks staff to reconcile insurance, imaging, and provider notes before a patient reaches the right schedule, creating avoidable touches without changing clinical judgment.

Riverbend Orthopedics is a fictional three-location specialty practice used as an exemplary healthcare assessment. Its public patient journey includes referrals, imaging records, insurance verification, scheduling, and post-visit instructions, so the credible opportunity is administrative intake and coordination rather than automating clinical decisions.

17-42h

weekly capacity range

$30,600

conservative annual value

$50,400

likely annual capacity value

1.2 mo

illustrative build-only payback

Planning estimate, not guaranteed savings. Model uses 50 working weeks, $36/hour loaded cost, and a $5,000 illustrative entry build. Validate volumes, handling time, adoption, and integration scope in discovery.

What we found

The evidence behind the recommendation.

Front-office and referral staff likely receive faxes, portal uploads, calls, and incomplete referral packets, then re-key demographics and insurance data, request missing records, and route each case to the correct location. Clinical staff remain responsible for triage, diagnosis, and care decisions.

Referral packets require six named input categories.
Provider availability differs across three locations.
The site publishes multiple form and record-release paths.
S1Aug 20, 2026

Patient referral page (fictional template)

Lists required demographics, insurance card, imaging, provider note, diagnosis, and preferred location.

S2Aug 20, 2026

Locations page (fictional template)

Shows three clinics with different provider and imaging availability by weekday.

S3Aug 20, 2026

Patient forms page (fictional template)

Provides separate new-patient, surgery, therapy, and records-release forms with submission instructions.

Opportunity map

Specific workflows, bounded assumptions, measurable outcomes.

01

Referral packet completeness review

The practice publishes a multi-document referral checklist that repeats across three locations and is separable from clinical triage.

8-19h/wk

$14,400-$34,200 annual capacity

Current hypothesis

Referral staff likely open faxed or uploaded packets, identify the patient and referring provider, check six required input categories, and request missing insurance, imaging, or notes.

Proposed system

A HIPAA-scoped intake service classifies the packet, extracts administrative fields, checks completeness, and presents a source-linked exception queue for staff approval before outreach.

Confidence

medium. Required packet fields are explicit, while referral volume and current extraction tooling remain assumptions.

Implementation window

4-6 weeks

Success gate

95%+ required-field detection with every extracted value linked to the source page and human approval on exceptions.

Show model assumptions and evidence
  • 150-220 referrals per week across three locations.
  • Initial completeness review averages 3-5 minutes per referral.
  • Evidence references: S1, S3

02

Location-aware scheduling preparation

Three sites with differing provider availability create a repeatable constraint-matching problem before staff confirm a slot.

5-12h/wk

$9,000-$21,600 annual capacity

Current hypothesis

Staff likely cross-check requested specialty, provider availability, imaging needs, insurance constraints, and location preference before offering appointment options.

Proposed system

A scheduling-prep assistant assembles verified administrative constraints and proposes eligible slots; staff select and confirm the appointment without delegating medical urgency decisions.

Confidence

medium. Multi-location availability is public, but scheduling rules, payer constraints, and EHR APIs require discovery.

Implementation window

5-6 weeks

Success gate

Reduce pre-scheduling handling by 50% with zero appointments offered outside configured administrative rules.

Show model assumptions and evidence
  • One hundred referrals per week reach scheduling.
  • Constraint gathering takes 3-6 minutes before slot selection.
  • Evidence references: S1, S2

03

Post-visit instruction and records routing

Multiple published forms and three locations create repetitive administrative routing after a clinician has made the care decision.

4-11h/wk

$7,200-$19,800 annual capacity

Current hypothesis

Teams likely select the correct instruction packet, records form, or therapy handoff, personalize administrative details, and send or upload it after the visit.

Proposed system

A rules-based workflow assembles the approved packet from visit disposition, checks patient and destination fields, and queues it for staff release with a complete audit trail.

Confidence

low. The forms are public, but visit disposition data and current routing workflow are not visible externally.

Implementation window

4-5 weeks

Success gate

Ninety percent of eligible packets are review-ready with zero wrong-patient or wrong-destination releases.

Show model assumptions and evidence
  • Two hundred qualifying visits per week.
  • Administrative assembly and routing averages 2-4 minutes per visit.
  • Evidence references: S2, S3

Recommended first project

Referral packet completeness review

It addresses a published administrative checklist, leaves clinical triage untouched, and supports a measurable shadow-mode pilot before any workflow write-back.

Pilot scopeProcess a limited set of de-identified historical packets, then run two weeks in shadow mode with no automatic outreach or EHR write-back until security and accuracy gates pass.
Timeline4-6 weeks
Go / no-go gate95%+ completeness detection, source-linked extraction, zero PHI sent outside approved systems, and eight staff hours reclaimed weekly.

What we still need to verify

  • Referral volume, payer mix, EHR, and fax vendor are not public.
  • Any implementation requires a signed BAA, security review, and human validation of extracted PHI.

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Soxoa LLC · Sacramento, CaliforniaFictional template · not a customer result or savings guarantee