From fax to
booked procedure.
01 Referral Intake
Every referral classified the moment it arrives.
Urgent, symptomatic, and screening cases land in separate queues immediately, with no manual sorting required.
Urgency routing
Stat cases (rectal bleeding, anemia) are separated from symptomatic and screening referrals automatically so urgent patients never sit in the same queue as routine colonoscopies.
Continuous monitoring
Batch processing runs three times daily. No referral waits until someone gets to it.
Checked every 10 seconds · batch processed 3×/day
Clinical Criteria Check
02 Referral Validation
Every gap caught before it reaches your queue.
Incomplete referrals are flagged and returned to the referring provider specifying exactly what is missing, before any staff member touches the file.
Documentation completeness
Labs older than 60 days, missing imaging reports, incomplete hospital records: flagged automatically, with a fax-back sent to the referring provider.
Clinic-specific clinical criteria
GERD cases require a documented 8-week PPI trial with dates. Diarrhea referrals require current labs and stool studies. Cases that don't clear are rejected before any staff touches them.
Frequency and geography
Patients with a colonoscopy in the last year and addresses outside your service area are filtered at intake, not after a scheduler has already spent time on the file.
03 Eligibility
Every patient verified before a slot is offered.
Carrier rules are applied automatically. Ineligible cases are excluded before they consume any scheduling capacity.
Payer-specific routing
Carrier rules are applied automatically. Certain payers route to specific physicians, require end-of-day slots, or have facility restrictions. No staff lookup required.
Ineligible cases filtered early
Referrals that don't meet insurance criteria are excluded before they consume any scheduling capacity.
Payer Routing Engine
Aetna
Colonoscopy (45378)
UnitedHealth
Upper endoscopy (43239)
Cigna
Colonoscopy (45380)
Denial docs staged automatically · No staff rebuild required
04 Prior Authorization
Submitted same-day. Tracked automatically.
Colonoscopies, upper endoscopies, and capsule studies frequently require payer authorization before they can be scheduled. TriFetch identifies the requirement, populates the request, and submits it without staff involvement.
Automatic identification and submission
Authorization requirements identified by payer and procedure code at intake. Requests populated from the referral and submitted same-day for qualifying procedures.
Denial management
Denied authorizations are flagged with supporting documentation staged for appeal. Staff do not need to rebuild the case from scratch.
Linda · AI Outreach Call
LiveLinda
Hi, this is Linda calling from GI Associates. I'm reaching out to schedule your colonoscopy referral.05 Patient Scheduling
Booked and confirmed. No coordinator required.
Linda contacts the patient after eligibility clears, schedules the procedure, and completes a structured pre-procedure intake, all logged directly to your EHR.
AI phone outreach
Linda contacts the patient, schedules the procedure, and completes a structured pre-procedure intake: BMI, cardiac history, diabetic status, driver confirmation, high-risk medications.
Every interaction is logged directly to the EHR
Every call, every outcome, and every patient response is written to the chart automatically. Nothing falls through.
Chart Creation · Patient #4 of 5
Up to 5 charts created in parallel · 15–20 min total
06 EHR Integration
Charts built. Documents filed. Ready for approval.
Up to 5 patient charts created in parallel in 15 to 20 minutes. Staff approve each chart before it is finalized. Oversight without data entry.
Automated chart creation
Up to 5 patient charts created in parallel in 15 to 20 minutes, with all required fields populated from the referral and documents sorted into pathology, labs, insurance, and clinical notes.
Human in loop
Staff approve each chart before it is finalized. Oversight without data entry.
Ready to get started?