Current Intake Process
End-to-end, as it operates today.
This section serves as the functional specification for the user stories that follow. Every step, naming convention, and decision point described here must be accounted for in the build.
Step 1
Gmail Inbox Monitoring & Document Download
All inbound documentation arrives in a shared Gmail inbox (the "reimbursement" inbox). Documents come primarily from treatment sites via fax-to-email or direct email, and occasionally from territory managers or sales reps who forward documentation.
Email processing follows a FIFO order under normal conditions. When volume is high, the intake specialist labels emails by document type and prioritizes: approvals first, then pulmonologist evaluations, other insurance communications, and biomarker eval reports last.
Approximately 80–85% of emails in the inbox are actionable intake documents. The remaining 15–20% consists of internal communications, occasional invoices, solicitation emails, and claims questions (auto-forwarded out of the intake queue).
"I always just begin with downloading the PDF to a specific designated file… I have my downloads and then inside downloads, I have a specific folder that all of these go into."
Step 2
Page Sorting & Extraction
Each downloaded PDF is opened in Adobe Acrobat for manual page-level sorting:
- Cover page handling: ~90% of faxes include a cover page (always first when present). Cover pages may contain useful information (insurance details, scheduling) and are saved separately.
- Facesheet extraction: If the document contains a facesheet (patient demographics and insurance), it is extracted as a separate PDF using Adobe's Extract Pages function.
- Quick scan: Rapid visual pass through the remaining pages to confirm document type and verify single-patient content.
Step 3
Patient Lookup & Folder Management
Before filing, the intake specialist checks whether the patient already exists in both Salesforce and the shared file system:
- Salesforce search by patient name to find existing Account and Case records. If no record exists, the Account/Case creation process is triggered.
- Shared drive search by last name first, then by date of birth, to find an existing patient folder.
- Duplicate prevention: if a matching DOB appears for a different patient, no duplicate is created.
Patient folders organize by state and territory. Each patient gets a root folder with subfolders for ADMIN, CLINICALS, and DNU (Do Not Use / superseded documents).
Step 4
Naming Convention & Filing
Every document is saved using a strict naming convention manually applied via copy-paste: Lastname_Firstname DOB DocType Date.
Clinical documents are uploaded to the patient's Evaluation record in Salesforce. Insurance letters and payer communications are uploaded to the Prior Authorization record. Multi-select upload is used when multiple files are filed for a single patient.
Step 5
Email Organization
After filing, the intake specialist returns to Gmail to organize the source email:
- Email subject is renamed to match the patient naming convention for future searchability.
- A label is applied (e.g., "Intake Documentation" or "Insurance Communications").
- The email is moved to a folder organized by site or territory.
Step 6
Salesforce Data Entry
For new patients, the intake specialist creates an Account and Case in Salesforce with demographics, territory, and insurance information extracted from the facesheet. Fields include patient name, DOB, address, territory, treatment site, carrier, plan type, member ID, and group number.
For leads without a full Account, a Lead Conversion workflow is required — detective work when PHI is incomplete.