Pre-procedure navigation for independent GI practices

The week before the scope is where the case is decided.

Clearfield Clinical runs those seven days for you. Every contact is timed to the patient's actual slot, every reply reaches a person, and your staff get one short list the day before naming only the people who need a call.

7 DAYS OUT
GLP-1 plan
5 DAYS
Prep in hand
3 DAYS
Anticoagulation
2 DAYS
Diet change
1 DAY, 08:00
Clear liquids
1 DAY, 18:00
First dose
CASE DAY, 04:40
Second dose
09:40
Arrival
O
Oakline GI
Wed 6:00 PM
Hi Dana, it's Oakline GI. Time to start the first half of your prep. Take it over about two hours. Reply here with any questions.
I couldn't keep the second glass down, do I still come in tomorrow?
8:12 PM
Thanks Dana. A nurse from Oakline GI will call you this evening and tell you what to do next.
Text Message
Escalated to Oakline GI, 8:12 PM
Oakline GI Sat 5:00 PM
Hi Dana, it's Oakline GI. Quick check: do you have your prep kit at home yet? Reply YES or NO.
5:06 PMYES
Calculated from the slot
04:40second dose begins
Five hours before a 09:40 case. Change the case to 07:30 and this becomes 02:30, which is why early cases fail.
Thursday list · day-before brief 4 of 22
At riskWhitfield, D · 09:40 · could not tolerate dose one
At riskAlvarez, R · 07:30 · no response ×3, prep uncollected
WatchOkonkwo, M · 11:00 · prep collected two days late
5 DAYS OUT · SAT 5:00 PM
Hi Dana, it's Oakline GI. Quick check: do you have your prep kit at home yet? Reply YES or NO.
YES
1 DAY OUT · WED 8:12 PM
I couldn't keep the second glass down, do I still come in tomorrow?
Escalated to Oakline GI, 8:12 PM
CASE DAY · CALCULATED
04:40second dose begins

Five hours before a 09:40 case. A 07:30 case makes this 02:30, which is why early cases fail.

5.6–8.45%Endoscopy cancellation rate, ASGE benchmarking range
$312,000A year at two lost slots a day and a $600 facility fee, illustrative
4–6 hrsBefore the case, when the split-dose second half should begin
6 of 9Adequate prep on the Boston scale, at least 2 in each segment
Two
touches.Eight
decisions.

Most practices send instructions at booking and a reminder the day before. Between those two messages sit eight decisions a patient has to get right, at specific times, and a slot canceled the morning of cannot be resold.

Prep failure is not a memory problem. It is a week-long adherence problem, and reminders were never built for it.

What is sent
What is decided

You send the schedule. We run the days in between.

Nothing to install, nothing to integrate. Running before your next procedure block.

1

Export your schedule, once a week

From whatever you already use. A spreadsheet is fine. Six fields, nothing clinical.

patientdatetime
Alvarez, R09-1707:30
Whitfield, D09-1709:40
+ 20 more
2

Every touch is timed to the slot

Your protocol, your words. The second dose is calculated from each case, never from a template, and replies reach a person.

Case at09:40
First dose18:00, day before
Second dose begins04:40
Liquids stop07:40
3

One short list, the day before

Only the patients who went quiet or said something worrying, with what they said and what to do. No dashboard, no login.

Thursday list4 of 22
Alvarezno response ×3
Whitfieldcould not tolerate
Okonkwoprep collected late

Change the slot. Watch the sequence rebuild.

This is the difference between a reminder service and a prep service. The last three rows are calculated from the case.

Procedure time
Prep protocol
Contact sequence
Why the time matters

Hours before the case
DOSE MAY BEGIN 8h6h4h2h0 We schedule hereLiquids stop

Timing follows split-dose guidance from the US Multi-Society Task Force, ACG and ASGE. GLP-1 handling per the 2024 multi-society guidance. Your own protocol is what we would actually run.

What one point is worth to you.

Pick the three numbers closest to your practice. Everything else is arithmetic.

Your practice

Three numbers. Pick the closest.

Procedures a week
Facility fee per case
Cancellation rate

ASGE benchmarking puts endoscopy cancellations at 5.6% to 8.45%. Not all of those are same-day, so treat this as an upper bound. If you do not know yours, that is the first thing we would find out together.

Cases canceled a year
Facility fees on those cases
If prep navigation recovers one point of cancellation rate

Your tier
Clearfield, a year
Cases to break even

Estimates only, built from your inputs and published benchmarks. Not a guarantee of any outcome. Tier and fee reflect current founding-practice pricing.

Security and PHI

The compliance answer, before you ask for it.

We can name both of our subprocessors. Ask any vendor to do the same.

BAA before the first fileSigned before any patient data moves. Not after a pilot, not once the contract is final.
Six data elements, nothing clinicalName, phone, date, time, procedure, protocol. No chart, no diagnosis. Extra fields are stripped on receipt.
No AI touches patient dataOutbound is templated. Inbound replies are read by a person. Nothing trains a model, ever.
Two subprocessors, both under BAAGoogle Workspace and Twilio. United States only. You are told before a third is ever added.
Five-day breach noticeNot the sixty the rule allows. What happened, who is affected, what we did, what we recommend.
Returned or destroyed, in writingNinety days after the procedure, or sooner on request. On termination, within thirty days, confirmed in writing.

Priced by practice size. Paid for by a handful of saved cases.

Every tier works out to a few dollars a case. At a $600 facility fee it pays for itself on three to eight recovered cases a month.

Small · 2 to 3 physicians
$1,750/ month
Up to 350 cases a month, then $6 a case
Book 15 minutes
Mid · 4 to 8 physicians Recommended
$3,000/ month
Up to 800 cases a month, then $6 a case
Book 15 minutes
Large · 9 or more physicians
$4,500/ month
Up to 1,400 cases a month, then $6 a case
Book 15 minutes
Founding practices

For the first three practices: setup fee waived, your rate locked for 24 months, and cancel any time in the first 60 days with no notice and no fee. In return we ask for your prior-quarter cancellation figures before we start, one reference call, and permission to describe results anonymously with your sign-off on the wording.

Questions

The ones that come up first.

Do we have to integrate with our EHR?

No, and that is deliberate. A weekly export with six fields is all we take. Integration is the reason most of these projects take a quarter instead of a week.

We already send reminders. How is this different?

Reminders tell a patient the appointment exists. This runs the seven days of decisions before it, timed to their slot, and reads their replies. Keep your reminders. This sits in the gap they leave.

Who answers when a patient asks a clinical question?

Your staff. We answer logistics in your words, timing, volumes, what counts as a clear liquid. Anything clinical is routed to your designated contact the same day, and the patient is told that is what happened.

What does our staff actually have to do?

Send the export once a week and work a short list the day before each procedure day. Plan on ten to fifteen minutes.

Will you show us results?

Monthly: contacts delivered, response rates, escalations by reason, and same-day cancellations among navigated patients. We ask for your baseline first so the comparison means something. No practice results are quoted on this site because we are new, and we would rather say so than invent them.

Can patients opt out?

Instantly, by replying STOP. You are told the same day so you can reach them another way. Opting out never affects their appointment.

Who runs it
Tiger DeStefano
Founder, Clearfield Clinical
Tig Tech LLC, Austin

Clearfield Clinical is new and taking on its first practices. You should know that before the call, not after it.

What that buys you is that the first few practices get me directly and get to shape how this runs. I spend my working life inside enterprise client operations for financial institutions, running escalations and root-cause work where a failed transaction has a name and a cost attached. The pattern here is the same one: a small, predictable set of process failures quietly removing revenue that nobody has been made responsible for.

I build the automation myself. If your protocol is unusual or your patients need a different cadence, that is a conversation, not a support ticket.

Fifteen minutes, and two questions.

What share of your procedures cancel or no-show, and how many of those are prep-related? If you do not track those separately, that is the more interesting answer, and it is where we would start.