From first conversation to a decision to scale.
The sequence is deliberate: patient-level work begins only after contracting, workflow design, access controls, staff validation and practice approval are complete.
Three phases, twelve steps.
Open a phase to see the steps inside it. Nothing about your patients happens before phase two is complete.
Phase one Fit & scope
No agreement is required, and no patient information changes hands.
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01 — Fit conversation
Fifteen minutes on your population and your pressure
Who your patients are, where between-visit work is currently falling, and what your team is carrying.
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02 — Current-state review
How the work happens today
Who makes the calls today, what is documented and where, which systems are in use, and what happens when something needs a clinician. In aggregate, without patient-level detail.
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03 — Defined scope
A written proposal of the work
Which patients, which activities, which pathways, which reporting, and the pilot period, in enough detail that both organizations know what they are agreeing to.
Phase two Design & prepare
This phase turns the proposed scope into a documented operating workflow before patient-level work begins.
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04 — Contract and BAA
Agreement and business associate agreement executed
A services agreement covering scope, responsibilities, term and fees, and a business associate agreement covering protected health information. Both are executed before any patient data is exchanged.
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05 — Workflow design
The work written down before it is performed
Contact protocols and attempt schedules, documentation standards, escalation pathways with urgency levels and named recipients, and cover outside your business hours.
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06 — Staff and licensure validation
The right license for the activity, verified
Assigned staff confirmed as authorized to practice where the patient is located and for the activities in scope, with scope-of-practice boundaries written into the workflow.
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07 — Patient criteria
Who is in, defined by rule
Written inclusion and exclusion criteria, so the population is reproducible and both organizations can evaluate it later.
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08 — Practice approval and consent
Your sign-off on the actual list
Your practice approves the specific patients and makes any enrollment decisions that apply. Where a program requires patient consent, it is captured on your script, in your record, with any applicable cost-sharing disclosed. No patient is contacted before this step is complete.
Phase three Run & evaluate
The pilot is scoped to produce a decision at a defined point.
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09 — Outreach begins
Assigned staff start contacting your approved patients
To the protocol, on the schedule, with every attempt logged.
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10 — Escalation and documentation
Work recorded as it happens, concerns routed as agreed
Contemporaneous documentation in the agreed system of record. Anything meeting an escalation trigger goes to your named clinician through the defined pathway, with the response recorded alongside it.
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11 — Monthly review
A standing conversation about what happened
Engagement, documented clinical activity, escalations and how they resolved, exceptions, patients we could not reach, and a review of our documentation against the agreed standard.
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12 — Pilot decision
Continue, adjust, expand or stop
Both organizations decide against the measures agreed at the start. Continuing, adjusting and stopping are all defined outcomes.
Who is responsible for what.
Written into the agreement before work begins.
Anuvra
- Assigned clinical staff
- Approved outreach workflows
- Documentation
- Care coordination
- Agreed escalation
- Quality review
- Reporting
Shared
- Workflow design
- Patient criteria
- Performance review
- Pilot evaluation
Your practice
- Clinical direction
- Clinical decisions
- Patient enrollment approval where applicable
- Practitioner oversight
- Billing
- Claims submission
- Payer decisions
- Escalation response
Different responsibilities, one connected workflow.
Built around clear clinical boundaries.
Every one of these is settled in writing before the first patient is contacted, and each is reviewable afterwards.
Clinical direction
Your practice retains clinical decisions. Assigned staff carry them out; they do not substitute for them.
Scope
Assigned staff work within authorized scope and approved protocols, verified for where the patient is located and for the activities in scope.
Privacy
Patient-level work begins only after the applicable agreements, business associate agreement and secure workflow are in place.
Escalation
Triggers, urgency levels, named recipients and response pathways are defined before launch, not improvised during the first difficult week.
Documentation
Activity is captured contemporaneously through the agreed documentation workflow, attributed and timestamped.
Quality
Work is reviewed against the standards agreed with the practice, and the review is part of what you receive each month.
Auditable, as a document you can hold.
Each month the practice receives a written review before it is discussed. This is the format. The values are empty because we have no client results to show, and we will not invent any.
- Patients active
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- Patients reached
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- Outreach attempts
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- Escalations raised
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- Escalations resolved
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- Open items
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What we are seeing
Patterns across the population this month, in plain language.
What needs attention
Items requiring a decision from the practice, and by when.
Workflow exceptions
Where the agreed workflow did not hold, and what we propose to change.
Illustrative format only. No patient information and no client results are shown.
Asked in most first conversations.
Does Anuvra replace our clinical team?
No. Anuvra adds defined clinical capacity within agreed responsibilities and workflows. Your team keeps the patient relationship and every clinical decision in it.
Who retains clinical decision-making?
The contracting practice. Assigned staff work within protocols your practice approves, and anything requiring clinical judgment beyond those protocols is escalated for a clinician to decide.
Do we need another software platform?
Not necessarily. Workflow depends on the engagement and on the systems you already run. This is settled during workflow design, before launch.
Can Anuvra work inside our EHR?
Often, and it is the arrangement we prefer, because documentation belongs in the record your practice owns. What is possible depends on your system, access policies and security requirements, and is confirmed during current-state review. Where direct access is not workable, the workflow is agreed before launch and the same standards apply.
Does Anuvra guarantee reimbursement?
No. Coverage, coding, claim submission and payer decisions are the practice's responsibility. Anuvra provides clinical capacity and documentation of the work performed.
Does Anuvra help with coding or billing?
No. We provide clinical capacity and document the work performed. Coding, claim submission and every payer decision belong to your practice, and we do not advise on them. Where our documentation supports a program your practice bills, that is a consequence of the work being done properly. How the economics work sets out the mechanism in full.
We are already talking to a full-service care-management vendor. How is this different?
Mostly in how each of us is paid, and in what that does to the incentives. Full-service vendors in this market are commonly paid a share of what the program collects. Anuvra is never paid a percentage of your collections; our fee is fixed against an agreed scope.
That matters because your practice is the billing entity and carries the compliance exposure. A vendor whose income rises with billable months has an interest in enrollment volume and in months crossing the time threshold. Ours does not move either way. The second difference follows from the first: we are built to be small and specific rather than to enroll at volume, so a founder runs your implementation and the pilot is designed to be measured honestly, including when the answer is no.
Where can Anuvra staff work with patients?
Anuvra is based in Columbus, Ohio. Nursing practice is generally treated as occurring where the patient is located, so coverage depends on patient location, the authority under which an assigned nurse practices there, and applicable scope requirements. Coverage for your population is confirmed during current-state review.
Reported either way.
Core reporting focuses on engagement, documented clinical activity, outreach attempts, escalations, unresolved items, workflow exceptions and other measures agreed before launch.
Where the practice supplies appropriate claims or outcome data, the pilot may also review reimbursement experience and agreed clinical or operational outcomes. Reporting includes the gaps and the exceptions.
Step one takes fifteen minutes.
Start with a short conversation about your patient population, workflow and current staffing pressure.