Priority tier
Best current route
Decision owner
Enter
Clinical hook
Controlled pilot
Five-business-day fallback
Directional planning aid — not an audited measure
Documents
Everything this firm receives.
Evidence ledger
Every claim carries a status and a source.
Outreach library
Locked until the contact is verified.
Operating flow
Advance only when the exit requirement is met.
Required action
Exit requirement
Outreach sequence
Ten steps, day 0 to day 45.
Pilot scorecard
Eight measures. Seven carry a target.
Account ownership
One owner. One dated next action.
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Non-negotiable controls
Clinical necessity first.
Clinical decisions remain independent.
No guaranteed diagnosis, causation, or legal result.
No payment or fee tied to referral or case value.
No PHI in this workflow.
Use approved authorization and record-release processes.
Reverify every contact before outreach.
Care is recommended because the individual needs it, not because a case needs another bill.