Healthcare operations automation · Lawrenceville, GA

The operational layer underneath everything your stack can't see.

ARFA wires together the tools your practice already runs. Phone, fax, intake, scheduling, billing, documents, reporting. None of them were built to talk to each other. We build the workflows that bridge them.

Request a workflow leak review See what we build
BAA-gated stack
14-day narrow pilot
No rip-and-replace
Inbound call → Triage → EHR
LIVE
📞 Voice In 🤖 Triage AI 📋 EHR Sync 📊 Dashboard ✓ Logged · 1.4s
12:42:01 ● Call received, first ring
12:42:03 ● Intent: booking, confidence 0.94
12:42:04 ● EHR write: appointment created
12:42:05 ● Audit row written, 1.4s end-to-end
What we build

Six categories of workflows. Each one a specific revenue or time leak.

Most operational pain in an independent practice comes from work that happens between systems your existing software doesn't connect. ARFA builds the connective tissue. Start with one workflow. Add the rest as confidence grows.

📞
Phone & SMS
Inbound voice + recovery
  • Voice receptionist (first-ring pickup, 24/7)
  • Missed-call recovery with text-back in 2 minutes
  • Two-way SMS triage and booking
  • Outbound no-show reactivation calls
  • Insurance verification call routing
📠
Fax automation
Inbound fax intake
  • Faxed referrals parsed into structured intake
  • Lab results routed to the ordering provider
  • Records-release fax automation
  • Referring physician confirmation cascades
  • Auto-classification by document type
📋
Intake & scheduling
New patient onboarding
  • Online booking with EHR sync (live demo)
  • New patient intake forms, pre-populated
  • Pre-visit document chase (insurance card, ID)
  • Appointment reminders by SMS or email
  • Reschedule and cancel cascades
💳
Billing & authorization
Revenue cycle workflows
  • Prior auth tracking dashboard
  • Insurance denial alert workflows
  • Claim resubmission triage
  • Patient statement follow-ups
  • Eligibility verification automations
📊
Operations & reporting
Staff dashboards and KPIs
  • Role-filtered staff queue (front desk, clinical, billing)
  • Daily and weekly KPI reports
  • Stuck-deal and aging-task alerts
  • Custom revenue leak audits
  • NotebookLM-ready research bundles
📄
Documents & compliance
Document workflows
  • Records release automation
  • Document expiration tracking (licenses, insurances)
  • BAA-gated document intake portal
  • E-signature workflows
  • Audit log export for compliance review
How a pilot starts. You pick the one workflow leaking the most revenue or staff hours right now. We build that, deploy it on the BAA-gated stack, and prove the savings in 14 days. The other workflows expand from there only when the first one is stable and the math is on the table.
Who this is for

Independent practices leaking revenue through broken workflows.

Every vertical below leaks money in a slightly different way. ARFA was built to find the leak and plug it. Click a card with a link to see the specific automations.

🦷
Dental
Miss one cosmetic call. Lose a multi-thousand-dollar case.
High-value cosmetic patients rarely leave a second voicemail. They book the next cosmetic dentist on the search results.
View automations
📋
ABA / Behavioral Therapy
Clean clinical work. Denied anyway.
Most ABA denials aren't about care quality. They're a missing modifier, an unsynced note, or an auth that lapsed. RBTs write from memory hours after the session, and the defect surfaces 60 days later as a denied claim nobody traces back.
View automations
🌀
Chiropractic
Pain doesn't wait for voicemail.
Acute injury calls after-hours route to urgent care the second voicemail picks up. Most book with whoever answers first.
💉
Med spa
Speed closes. Voicemail doesn't.
A patient DMs your Instagram. If you don't reply in five minutes, they book the next IG-active spa on their feed.
💧
IV / Wellness
Same-day demand or nothing.
Most IV bookings happen the day they call. Miss the first ring and the patient books somewhere else within minutes.
🏥
Direct primary care
Slow onboarding kills retention.
Patients paying monthly expect immediate onboarding. Every delay creates a cancellation before loyalty ever forms.
🦴
Physical therapy
Empty treatment hours compound fast.
Expired auths, missed reactivations, and gaps in the schedule compound into lost revenue nobody notices until quarter close.
🩸
Labs & mobile phlebotomy
First responder wins the contract.
B2B accounts go to whoever picks up first and follows up consistently. Slow dispatch loses recurring contracts quietly over months.
⚕️
Specialty & weight loss
GLP-1 demand buries front desks.
High-volume weight loss inquiries overwhelm small admin teams in days. Manual triage creates bottlenecks before anyone realizes it.
🏡
Long-term care
Incidents and family calls outpace staff.
Skilled nursing and assisted living drown in incident intake, family communication, and survey documentation. Slow escalation becomes compliance risk and staff burnout.
Live demos

Three workflows. Walk through any of them with me.

Synthetic patient data, BAA-gated stack, end-to-end traceable. Same pattern extends to every category above.

01

Voice receptionist

Every call answered on the first ring. Booking, refill, billing, or urgent triaged in under 2 seconds. Last-name plus date-of-birth verification before any patient info is disclosed. Emergency cases route to 911 with an audit trail.

📞
02

Missed-call recovery

If a call drops, rings out, or comes in after-hours, the patient gets a text back within 2 minutes. The lead lands in the dashboard automatically. Nothing leaks even when something upstream breaks.

✕
Missed call · 7:42 PM · 770-555-0142
↓
✓
SMS sent · "Hi, we missed your call, book here"
03

EHR sync and routing

Every appointment, refill request, callback, or escalation flows into the right staff queue. Categorized, tagged with an action verb, audit-logged. Front desk only sees scheduling. Clinical only sees medical. Billing only sees insurance.

BOOK Sarah Chen, new patient 2s
VERIFY Mark Johnson, insurance 5s
REFILL Lisa Park, lisinopril 8s
CALL D. Wilson, followup 12s
The stack

What's running in the background.

I built ARFA on a small, deliberate stack. Every tool was chosen for a specific job and a signed Business Associate Agreement. Plain English on what each one does:

Retell, the voice layer

A voice platform that picks up the phone, listens to the patient, and has the actual conversation in real time. Verifies last name and date of birth before disclosing any patient information. Tested across 31 adversarial scenarios (social engineering, profanity, controlled-substance probes).

Claude via AWS Bedrock, the language model

A production language model that classifies what each call is actually about (booking, refill, billing, urgent) and decides where it goes next. Bedrock is Amazon's enterprise hosting layer that comes with a signed BAA covering Claude.

n8n, the workflow engine

An open-source automation engine that wakes the moment a call ends and routes the data: book in the scheduler, log to the dashboard, send the SMS, page the on-call clinician, parse a fax, route a denial alert. Idempotency keys mean a retry can't double-book. Latency budget under 800 milliseconds end-to-end.

NocoDB, the database

A self-hosted database where patient information lives temporarily. Runs on our own DigitalOcean server. Every read and write is timestamped, user-tagged, and queryable. SOC 2 evidence-ready from day one.

Twilio, the telephony layer

The carrier-grade backbone that handles the actual phone calls and sends every SMS. Covered by Twilio's signed Business Associate Agreement.

The staff dashboard

Custom-built. What your team actually opens in the morning. Role-filtered (front desk only sees scheduling, billing only sees insurance). Drag-to-update status. Audit trail per row.

Every tool above was selected because it offers a signed Business Associate Agreement for HIPAA-covered data. Tools without a BAA, like standard public LLM APIs and open-routing aggregators, are never on the path.

📞
Retell
Voice layer · first-ring pickup, transcript, intent
BAA signed
🤖
Claude via AWS Bedrock
Production language model · triage and refusal logic
BAA signed
⚡
n8n
Workflow engine · routing, idempotency, audit
Open-source · BAA via host
🗄️
NocoDB on DigitalOcean
Database · patient data, audit log
Signed after contract
📨
Twilio
Telephony and SMS · calls in, messages out
BAA signed
📊
Staff dashboard
Custom-built · role-filtered queues, drag-to-update
Internal · no PHI in transit
HIPAA & compliance

Every tool that touches patient data has a Business Associate Agreement before the first real call.

Synthetic data only until then. No real PHI in any demo. The matrix below is exhibit A in every proposal.

Defaults that protect you

  • ✓
    BAA-gated by default No real patient data touches anything until every Business Associate Agreement is signed. Synthetic data only for demos.
  • ✓
    Audit log on every access Every PHI touch is timestamped, user-tagged, and queryable per call, per row, per minute. SOC 2 evidence-ready.
  • ✓
    Verification before disclosure Voice agent verifies last name and date of birth before any patient-specific information is disclosed. Wrong DOB means the agent refuses politely.
  • ✓
    Graceful degradation If the model has an outage, the voice agent falls back to a scripted hold sequence and pages the practice cell. The patient never hears a stack trace.
  • ✓
    Exportable data, always Every row, every transcript, every audit entry is yours. Standard formats. No vendor lock-in. Walk away with everything at any time.

BAA matrix, exhibit A

Tool / layer Status
Production language modelSIGNED
Voice gatewaySIGNED
SMS gatewaySIGNED
Intake / schedulingSIGNED
Compute / database hostSIGNED AFTER CONTRACT
Public LLM APIsNEVER USED
Open-routing aggregatorsNEVER USED

Two tools at the bottom (public LLM APIs and open-routing aggregators) are never used for any practice we work with. They don't have BAAs. They aren't on the path.

ARFA mark
Arfa McClain
MHA · Healthcare AI operations
Lawrenceville, GA
About

Production-engineering discipline applied to the back of the house.

I built ARFA after watching independent practices try to solve operational problems with software designed for hospital networks. The mismatch is everywhere. Practice management systems that don't know what the phone did. EHRs that can't see after-hours calls. Dashboards that show everything to everyone instead of routing what matters to who needs it. Fax workflows that still rely on someone walking a piece of paper across the room.

Most AI-for-healthcare pitches today are vibe-coded prototypes pretending to be production systems. ARFA is the opposite. Narrow scope, signed BAAs before the first real call, idempotent writes, dead-letter queues for failed parses, audit logs you can query. The dashboard your staff opens Monday morning is just the visible layer. Underneath is the discipline.

One operator, deliberate scope, no rip-and-replace. Pilots take 14 days. The math you'll get back when you reply to this page is your own. Your call volume, your patient lifetime value, your specific workflow leaks. No deck, no slides.

Workflow leak review

Send your numbers. Get a one-page leak estimate.

Your weekly call volume plus a rough estimate of how many go unanswered. You'll get back a leak estimate and the three workflows worth piloting first. No deck. 15 minutes if the math looks worth talking through.

Or email arfa.consults@gmail.com.

Want this mapped to your specific practice? Request a workflow leak review