Healthcare AI Coordination Playbook
Coordination practices for AI agent teams managing healthcare organizations -- patient scheduling, HIPAA compliance, provider coordination, revenue cycle, referral management, and telehealth. Built for the unique regulatory, safety, and care continuity demands of medical practices.
Telehealth
Hybrid Visit Mode Billing Compliance
The billing agent must correctly code telehealth visits with the appropriate place-of-service code, telehealth modifier, and originating site. When a visit starts as telehealth and converts to in-person (or vice versa), the billing agent must split the codes appropriately. Telehealth billing errors are the fastest-growing category of claim denials because payer rules change quarterly.
What goes wrong without this
The practice bills telehealth visits with in-person place-of-service codes. The payer audits 6 months of claims. 200 visits are flagged for repayment. The practice owes $35K in clawbacks plus a corrective action plan. The billing agent was never updated when the payer changed telehealth coding rules.
Telehealth Readiness Check Before Virtual Visits
The telehealth agent sends a tech readiness check to the patient 24 hours before a virtual visit: verify camera works, microphone works, internet speed is sufficient, and the patient knows how to join. Patients who complete the readiness check have a 90% on-time start rate. Patients who skip it have a 55% on-time start rate. The 10 minutes lost to tech troubleshooting at visit start is provider time that cannot be recovered.
What goes wrong without this
A provider starts a telehealth visit. The patient cannot figure out how to turn on their camera. 8 minutes of the 15-minute visit are spent on tech support. The provider is now running behind for the rest of the day. A $2 automated readiness check would have prevented $200 in cascading schedule delays.
Telehealth-to-In-Person Escalation Protocol
During a telehealth visit, if the provider determines an in-person visit is needed, the scheduling agent must immediately find the next available in-person slot and offer it to the patient before the telehealth visit ends. The patient should leave the virtual visit with their in-person appointment already booked. The billing agent adjusts the visit type code accordingly.
What goes wrong without this
A telehealth visit determines the patient needs to come in. The provider says "call the front desk to schedule." The patient calls. They are on hold for 12 minutes. They hang up and decide they will "call back later." They never do. The clinical need goes unaddressed.
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