Collect registration, coverage and symptom detail, retrieve the prior record and hand the nurse a structured intake — with identity checks, red-flag escalation, audit trails and clinician-assigned acuity.
Take registration, demographics, coverage and reason-for-visit detail from the portal, phone line, kiosk or schedule.
02
Retrieve the existing chart — problem list, medications, allergies and prior encounters — once identity is verified.
Reason
03
Normalise what the patient wrote into coded problems, medications and allergies, keeping the original words beside it.
04
Work the client's approved protocol question set, branching on the answers already given rather than asking everything.
05
Check the payer eligibility response against the coverage already on file and mark where the two disagree.
Decide
06
Detect a stated red flag, stop the question set and hand the session to a person immediately.
07
Detect thin, contradictory or low-confidence capture and route it to the intake queue for a person to complete.
Out
08
Present a structured intake — the patient's own words, the coded capture, the retrieved record and what is still missing.
09
Retain the transcript, the sources read, the protocol path taken and every correction a reviewer makes.
→Product statement
The agent gathers, structures, retrieves and presents. Acuity, care setting and any clinical instruction to the patient stay with a qualified clinician.
Example workflow
One intake, end to end
AgentHuman
1Intake openedPatient portal, phone line, kiosk, secure message or a scheduled-visit prompt
2Identity verifiedChecked against the agreed fields before any record is retrieved or read back
3Reason and symptoms capturedThe patient's own words first, then the approved question set in the branch those words open
4Record and coverage retrievedProblem list, medications, allergies, prior encounters and the payer eligibility response
No human action required
Stages 1 to 4 run without a person in the loop — capture and retrieval finish before anyone is asked to read anything. A stated red flag ends that stretch on the spot.
5DecisionSplits on stated red flags and capture confidence
No red flag, capture complete
Reaches the nurse's queue ready to read.
Red flag or thin capture
Goes to a person immediately, ahead of the queue.
Nurse or clinician
Reads the patient's own words, the coded capture and the retrieved record, then assigns acuity and the care setting.
Triage · Correct capture · Call the patient
Triaged — handed back▼
6Intake filed and queuedWritten to the encounter only where write access and policy allow; the acuity field stays empty
7Outcome evaluatedCapture completeness, red-flag escalation, agreement with the nurse's decision and corrections by cohort
Corrections
Capture that the nurse rewrites is counted in the evaluation.
What should not run autonomously
Human approval stays in control
Outside the boundary — human approval required8 items
Assigning an acuity level or triage score.
Choosing the care setting or level of care.
Telling a patient what to do clinically.
Deciding a red-flag session can wait in a queue.
Automation boundaryAgent acts unaided
✓Capture registration, coverage and reason-for-visit detail from the patient.
✓Work the approved protocol question set and record the answers verbatim.
✓Retrieve the chart, problem list, medications and allergies once identity is verified.
✓Escalate a stated red flag to a person and route thin capture to the queue.
Write actions run only inside the approval boundaries agreed during implementation. The acuity field is not one of them.
Confirming a patient match on weak identifiers.
Merging, unmerging or amending an existing chart.
Recording a coverage or eligibility decision as final.
Changing protocol question sets or red-flag rules.
Example output
One intake session, annotated
Everything the agent presents is attached to the session and the record it came from.
Intake output · single pre-visit sessionIllustrative example
Patient's words
Channel
Identity
Handed to
Confidence
Acuity
Chest tightness since this morning
Pre-visit portal, English
Verified, 3 fields
Nurse — now, not queued
91%
Not assigned by the agent
As receivedThe patient's own words and the channel they arrived on, kept verbatim beside the coded capture — nothing on this side is rewritten.
Evidence usedThree-field identity matchProblem list and medicationsChest-symptom branch
Why it went straight to a personThe wording matched the client's red-flag list, so the agent stopped the question set and paged a nurse.
ActionTriageCorrect captureCall the patient
What the score decidesConfidence decides how much the nurse should re-ask, not how urgent the patient is. A clinician assigns acuity.
Value
Where AI adds value
The same four claims, placed at the point in the workflow where each one applies.
Where the value landsValue 01 – 04
Every arriving patientPortal, phone, kiosk or scheduled visit
03Capture & retrieval
Apply the client's own protocol
Use the approved question sets, red-flag list, identity rules and the record already on file.
01Approved path
Take the keying off the front desk
Registration, coverage and history arrive already structured, so the nurse starts from a complete summary rather than a blank form.
02Human review
Put a person in front of the patient sooner
Stated red flags and thin capture reach a nurse immediately instead of waiting their turn behind routine intake.
04Build an evidence trail
Retain the patient's words, the coded capture, the sources read, the protocol path, the confidence and the nurse's correction — on both paths.
Integrations
Typical integrations
Five system groups connect to the same agent. Which of them are in scope is decided in discovery.
EHR & registrationEpic · Oracle Health · athenahealth MEDITECH · registration APIs
Capture quality is not spread evenly across patients
Aggregate capture can look acceptable while a small number of patient cohorts carry most of the re-asking, most of the nurse corrections and most of the escalation risk. Nestack reports performance by slice, not only in total.
Slice performance — reported separately, not only in aggregateIllustrative example
Slice
Failure rate
Lift
Lift vs. threshold
Status
Non-English intake sessions
5.4%
3.4×
Review
Older adults, atypical presentation
4.3%
2.7×
Review
First-time patients, no record
3.0%
1.9×
Watch
Routine scheduled-visit intake
1.0%
0.6×
Normal
Bar: lift vs. scheduled-visit baseline · scale 0–4.0× · tick marks the 2.0× review threshold2 of 4 slices over threshold
Evidence-linked improvement
Every miss becomes a question the next patient is asked
A missed escalation is not closed when it is fixed for one patient. It changes the question set, the red-flag list or the retrieval rule.
Improvement cycle · five stagesSwitchback — the path turns at Improve and returns at Learn
01Detect
Red-flag recall, re-asking or nurse corrections move in a cohort.
02Diagnose
Traced to identity match, retrieval, symptom coding, the branch taken or the escalation rule.
03Improve
The question set, red-flag list or retrieval rule is re-approved clinically and version-linked.
04Verify
Re-run against held-out sessions from the affected cohort, including the ones that failed.
05Learn
That session becomes a regression case and the changed rule enters the intake runbook.
Learn → DetectThe return edge. A change to the red-flag list is a clinical change — it is signed off before it ships, not after.
Typical build scope
Twelve workstreams across six weeks
The build scope read against the delivery timeline. Week structure follows the six-week plan — discovery, capture, retrieval and coding, evaluation, integration, then production validation and handover.
WorkstreamWeek 1Week 2Week 3Week 4Week 5Week 6
01Workflow discovery and automation-boundary definition.
02EHR, scheduling and eligibility API assessment.
03Protocol question sets and red-flag list, clinically approved.
04Identity verification and consent rules.
05Intake capture on the agreed channels.
06Symptom normalisation and coding.
07Prior-record and coverage retrieval.
08Escalation routing and nurse handoff workflow.
09Red-flag recall and subgroup evaluation.
10Language and accessibility testing.
11EHR write-back and triage-queue integration.
12Observability, deployment and Agent Care handover.
12 workstreams · 6 weeks · bar shows the weeks a workstream is active — several run in parallelFinal scope and sequence confirmed in discovery
Engagement tiers
What each tier includes
Rows are the capabilities named in each tier's scope. Higher tiers include everything below them.
Capability✓ in scope · — not at this tierPilotOne intake channelProductionProduction EHR integrationAdvancedMulti-site / multi-channel
Introduced at Pilot
Structured intake capture✓✓✓
Identity verification and audit logging✓✓✓
Red-flag escalation to a person✓✓✓
Acuity assigned by a clinician✓✓✓
Baseline evaluation✓✓✓
Introduced at Production
Client protocol question sets—✓✓
Prior-record and coverage retrieval—✓✓
Nurse handoff and EHR write-back—✓✓
Observability and evaluation—✓✓
Introduced at Advanced
Multi-language and accessibility capture——✓
Multi-site and enterprise controls——✓
Build priceFrom $5,000From $8,000Custom quote
Final build priceConfirmed after discovery based on intake channels, EHR and eligibility integrations, patient volume, protocol complexity, approval controls and deployment requirements.
Separate from buildBuild pricing is separate from recurring Agent Care, which covers managed monitoring, evaluations, incidents and verified improvements after launch.
What we need from you
What you bring, and what we build with it
Each input maps to a piece of build scope and a week in the delivery timeline.
You bringWe build with it
01Your approved triage protocol and red-flag list→Protocol question sets and red-flag list, clinically approvedWeek 1
02Registration, demographic and coverage field requirements→Intake capture and eligibility field mappingWeek 2
03Access to EHR, scheduling and eligibility APIs→Epic and athenahealth registration, schedule and eligibility feedsWeek 2
04Identity-verification, consent and minimum-necessary rules→Identity gate, disclosure scope and audit loggingWeek 2
05Real intakes that went wrong, including the near misses→Evaluation suite, regression cases and failure-mode testingWeek 4
06The languages, reading levels and channels your patients use→Language, accessibility and low-literacy capture testingWeek 5
07Named triage nurses and clinical reviewers→Nurse handoff workflow, then pilot sessions and production validationWeeks 5–6
Nothing else is requiredDeployment, documentation and Agent Care handover are ours.
Delivery timeline
Four phases across six weeks
Phases are drawn over the weeks they actually occupy. Week 5 carries both the subgroup evaluation and the first supervised intake sessions.
PhaseW1W2W3W4W5W6
DiscoveryW1
BuildW2 – W3
EvaluateW4 – W5
Pilot & LaunchW5 – W6
Week focusW1Triage protocol and red-flag list approved by your cliniciansW2Identity, consent and capture on the first intake channelW3Symptom coding, record retrieval and escalation routingW4Evaluation suite, red-flag recall testing and subgroup slicesW5EHR integration, supervised intake sessions and targeted correctionsW6Nurses triage from live intake sessions, then Agent Care starts
Reading the bandRed-flag recall is tested in week 4, before any supervised session runs in week 5. Nothing reaches a patient until it has.
At the end of W6Intake has run alongside the existing process and been read by the nurses who triage from it, then Agent Care takes over monitoring.
DurationSix-week plan shown · typical delivery 4–6 weeks depending on scope confirmed in discovery.
Next step · Healthcare AI agent
Build an intake agent around your triage process.
Show us your intake channels, your approved protocol and red-flag list, and how a patient reaches a nurse today. We'll run one intake against your own protocol and test the red-flag list on your own near misses.
