AI-Powered Referral and Scheduling Automation for ENT Practices

ENT practices run at high volume. Appointments are 15 minutes each, meaning a full provider day holds up to 32 patients — but only when scheduling runs without friction. Practices carrying thousands of active referrals cannot staff their way out of the backlog. TriFetch automates the path from inbound referral to confirmed appointment, clearing the queue without adding headcount.

1. Referral Intake and Triage

Inbound referrals are pulled automatically from all channels as they arrive. No manual sorting or data entry is needed before processing begins.

• Active referral window of 30 days from receipt — referrals outside the window are flagged, not dropped.
• 80% of patients who call already have a referral on file. Matched automatically before the call reaches a scheduler.
• Unmatched calls routed to staff with a structured summary.
• Referrals that fail documentation requirements trigger an automatic fax-back to the referring provider.

2. Multi-Portal Eligibility Verification

ENT eligibility verification is more complex than most specialties. 80% of patients require verification across multiple insurance portals before a slot can be offered.

• Primary insurance portal check, secondary payer check, and IPA or medical group portal check run in sequence per patient.
• Required CPT codes added automatically based on diagnosis for pre-authorization where applicable.
• Eligibility determination completed in under 3 minutes per patient.
• Cases with missing coverage or failed verification filtered out before scheduling proceeds.

3. Provider and Appointment Routing

Not every patient needs an MD. Routing logic applies clinical logic to match each patient to the right provider level and appointment type.

• Mid-level providers offered first for appropriate cases: ear infections, hearing loss, dizziness.
• Specialist MDs offered only when mid-level is not appropriate or patient declines.
• Location-specific provider availability applied per site.
• Appointment type matched to visit category: new patient, follow-up, referred patient.
• 15-minute slot templates enforced across all provider calendars.

4. Patient Scheduling — AI Phone Agent

The AI phone agent handles all inbound patient calls: scheduling requests, referral status inquiries, and general questions. No dedicated scheduling staff required for routine calls.

• Scheduling calls trigger live eligibility verification before a time slot is offered.
• Agent collects patient name, date of birth, insurance details, and referral source during the call.
• Appointment booked directly into the EHR after patient confirms.
• Non-scheduling calls routed to staff with full call context and structured notes.
• Two-attempt outbound contact protocol for referred patients who have not yet called to book.

5. EHR Chart Creation and Document Management

Patient charts are created automatically from referral intake data. All documents are categorized and uploaded without manual handling.

• Patient chart created with all required fields populated from the referral.
• Documents categorized and uploaded: referral notes, labs, imaging, and insurance records.
• Appointment logged with provider, date, time, and visit type.
• Human approval checkpoint before the chart is finalized.