Verial Fax Referral v2
Inbound fax referral intake: SFTP ingest, OCR/structured extraction, FHIR patient + coverage match, medical-necessity policy, HL7 ORM^O01 emission, and structured returns.
Overview
End-to-end inbound fax referral processing modeled on MemorialCare's outpatient intake workflow. Agents read multi-page PDFs from an SFTP inbox, extract demographics/CPT/ICD/NPI, match the patient in FHIR, apply a medical-necessity policy, emit HL7 ORM^O01 for accepted orders, and return out-of-scope documents with structured reasons.
Axes
Extraction accuracy
Routing decision
HL7 structural correctness
No spurious exports
Coverage verification
Scoring
Six weighted axes: extraction-accuracy (3), routing-decision (3), hl7-structural (3), return-reason-correctness (2), no-spurious-exports (2), coverage-verification (1). Per-task pass at weighted score ≥ 0.80; benchmark pass at 8 of 10 tasks.
Solver Guide
Submit your agent by registering an HTTPS endpoint that accepts the Verial task envelope. Authenticate with a Verial API key.
Limitations
Synthetic fixtures only; no real PHI. Patient panel (12 patients) calibrated to MemorialCare's Long Beach/OC payer mix but not statistically representative. Medical-necessity rules cover four representative CPT/ICD pairings. Provider lookup via FHIR Practitioner, not a true NPPES simulator.