Phone line
Quiet.Clara is on the published number.
Incoming call(304) 555-0142 · Clara answering
Website
Quiet.Chat and forms feed the same queue.
New patient formSubmitted 7:59 · insurance attached
Messages
Quiet.Portal, voicemail, fax.
Portal messageRefill request · 8:00
Nothing waiting.
Monday, 7:58. Staff are not in yet. The line is answered anyway.
Three things in two minutes. None of them is in the queue yet.
A call, a web form, a message. Clara has the call. The other two are waiting for her to finish.
On the line · 7:58 · Clara
- ClaraThis is Clara, an automated assistant for the practice. I can transfer you to a person at any time.
- CallerI need to move my follow-up.
- ClaraI can look that up after I verify you. Please say your full name, date of birth, and the callback number we have on file.
- CallerJordan Hale, March 12, 1984, 304-555-0142.
- ClaraThank you. I have Thursday at 2:40. I’ll put that in the staff queue for release.
Chart · identity gate
- Name · matches
- Date of birth · matches
- Callback number · on file
Jordan Hale · existing patient
Thursday, 2:40
Follow-up. Slot held. Parked in the queue for staff release.
Clara can hear. Clara cannot release.
Queue · everything that arrived before 8:05
- Release
Existing patient follow-up
From the call · identity verified · Thursday 2:40 held
- Staff
New patient intake
From the website · insurance review · intake only until you say otherwise
- Prescriber
Refill request
Portal message · routed to the prescriber · nothing promised to the patient
- Now
Urgent callback
Voicemail · crisis language · 911/988 guidance already given
- Staff
Records request
Fax · routed to staff
Five things. One list. Nothing in it is released yet.
Queue
- Existing patient follow-upRelease
- New patient intakeStaff
- Refill requestPrescriber
- Urgent callbackNow
- Records requestStaff
One item is selected. The other four wait for the person they are tagged for.
Review
Existing patient follow-up · from the 7:58 call
- Patient
- Jordan Hale · identity verified (name, date of birth, callback number)
- Ask
- Move the follow-up. “I just need Thursday afternoon.”
- Proposed
- Thursday, 2:40 · slot held in the schedule
- Clara did
- Verified, looked up, held the slot, parked it here. Nothing written to the chart.
Waiting for a person. Nothing here is released because a model decided it. That includes this page.
Chart
Practice Fusion · appointment
Jordan Hale · follow-up · Thursday 2:40
Not written. Waiting for release.
Tamper-evident log
- 7:58Call answered. Clara identified herself as automated.
- 7:59Identity verified: name, date of birth, callback number.
- 7:59Schedule read. Thursday 2:40 held.
- 8:00Item parked in the staff queue. Tag: Release.
- 8:06Released by you. Appointment written to Practice Fusion.
- 8:06Sent back to staff by you. Nothing written.
Released or sent back, the log keeps both. Nothing leaves this board without a person’s name on it.
Practice settings · gates
- BAA signedPatient data stays in the United States.On · locked
- No PHI used for model trainingPractice data is not used to train foundation models.On · locked
- Identity before chartName plus date of birth, then a callback number or MRN, before any chart read.On · locked
- Human release requiredNothing patient-facing or chart-facing is finalized because a model decided it.On · locked
- Tamper-evident logEvery tool call and state change is written down.On · locked
- New-patient bookingOff unless the practice explicitly allows it. Intake stays intake-only.Practice’s call
Locked means the operator holds the key, not the practice. They do not turn off for a demo.
Stop rules by specialty
- New-patient intake without direct booking
- Crisis-safe routing to 911/988
- Refill routing to prescribers
- Controlled-substance requests flagged
- Adult-patient privacy protected
- New-patient lead capture
- Medical vs cosmetic routing
- Appointment request intake
- Photo and intake follow-up routed to staff
- Refill requests
- Appointment changes
- Sick-visit routing
- Insurance and medical records routing
- After-hours message capture
Clara · what she will not do
- Does not diagnose or give medical advice.
- Does not promise refill approval.
- Does not disclose chart information without verification.
- Routes crisis language to 911/988 guidance. Clara is not an emergency service.
- Says she is automated at the start of every call, and transfers to a person whenever asked.
Next step
Walk this on your practice.
Your published number and after-hours path. Website or chat lead into the same queue. Identity check before a chart read. Staff release into Practice Fusion or eClinicalWorks. What happens when Clara cannot act.
Independent practices in Virginia and West Virginia are on the live roster. This is not a health-system install.