Enquiry & Eligibility Assessment

Qualifying enquiries against funding eligibility and service availability.

896 hrs
All data is based on anonymized FullSpec mapping sessions and proprietary industry research. Learn more
Manual time identified
8
All data is based on anonymized FullSpec mapping sessions and proprietary industry research. Learn more
Companies have mapped
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About This Automation

Enquiry and eligibility assessment is the manual process of reviewing incoming care requests, gathering medical documents, and determining whether prospects meet facility criteria. Manual assessment creates delays, inconsistencies, and bottlenecks that frustrate families and slow admissions.

Automation reviews enquiries and documents against eligibility rules in real time, flags missing information, checks bed availability, and routes qualified prospects to the right staff member. Families receive confirmation within hours instead of days.

Key features:
Automatically extract and validate enquiry details from forms, emails, and phone intake records
Cross-reference medical history and care needs against facility eligibility criteria and care level definitions
Check real-time bed availability and suitability for the assessed care level
Flag missing documents and send templated requests for additional information
Route qualified enquiries to the appropriate care coordinator based on care level and availability
Generate structured assessment summaries and send immediate confirmation to families

Top friction points when done manually

The issues teams report most often with this process

#Friction pointCompanies Report This
1
Manual document review bottleneck
Care coordinators spend 20 minutes per enquiry manually reviewing medical records and determining care level.
80%
2
Inconsistent eligibility decisions
Manual checklist-based assessment leads to 22% inconsistency in eligibility determinations across staff.
67%
3
Slow family response time
2-5 day delays in confirming receipt and next steps frustrate families and damage reputation.
53%
4
Repeated follow-up emails
Missing documents require manual follow-up emails drafted individually, creating duplicate effort.
40%
5
Manual bed availability cross-reference
Staff manually check spreadsheets to confirm bed suitability, risking double-bookings and errors.
26%
DisclaimerAll data is based on anonymized FullSpec mapping sessions and proprietary industry research. Learn more

Automation readiness

How well-suited this process is for automation

Process Pain Score™Manual assessment creates 2-5 day delays, inconsistent decisions, and staff.
8.6/ 10
AI Fit Rating™Eligibility rules are deterministic; documents are structured; decisions follow.
9.1/ 10
Automation Lift Index™Automation reduces cycle time by 85%, eliminates manual routing errors, and.
8.8/ 10
Hidden Overhead™Context switching between emails, CRM, and spreadsheets; repeated follow-ups.
7.3/ 10

How The Automation Works

The full workflow, from trigger to completion.

1. Enquiry Submittedtrigger

Enquiry form is submitted via website, email, or phone intake form. The automation is triggered immediately with prospect name, contact details, and initial care needs.

2. Create Lead

Prospect record is automatically created with all submitted information, contact details, and initial care needs flagged.

3. Send Document Request

Automated email is sent to the prospect or family requesting medical history, GP referral, financial information, and other required documents using a standardized template.

4. Assess Eligibility Rules

The automation reviews the submitted information and any attached documents against the facility's eligibility criteria, including age, care needs, behavioral requirements, and funding eligibility. the automation flags any missing information or concerns.

5. Check Care Level Availability

The automation queries the occupancy spreadsheet and cross-references the assessed care level against available beds, returning real-time availability status.

6. Eligible and Beds Available?

The system checks if the prospect meets all eligibility criteria and if beds are available in the required care level. If yes, proceed to assignment. If no, route to exception handling.

7. Route to Care Coordinator

Qualified enquiry is automatically assigned to the appropriate care coordinator and a notification is sent with the assessment summary and next steps.

8. Send Qualified Response

An automated email is sent to the prospect or family within minutes confirming eligibility, outlining the next steps, and providing contact details for the assigned care coordinator.

Most popular tool stack used

— the complete tool combinations companies use
1
52% of companies
2
28% of companies
3
15% of companies
DisclaimerAll data is based on anonymized FullSpec mapping sessions and proprietary industry research. Learn more

What you get when you map this process

Everything you need to understand, plan, and build your automation.

ROI and business case

What this process costs today and what changes once it's automated.

Launch schedule

What gets built, in what order, and what success looks like once it's live.

Process runbook

How the automation runs day to day, including exceptions and human decision points.

Developer handover pack

Full build spec, logic, and configuration — ready to hand off without a briefing call.

Integration and connections guide

Every tool connection, credential, and data mapping the build needs.

Test and QA plan

Every scenario checked and signed off before the automation goes live.

Recommended for you

Other high-impact processes teams commonly map alongside this one.

Frequently asked questions

Everything you need to know before mapping this process.

The system automatically flags missing information and sends a templated request email to the family. If documents remain incomplete after a set period, the enquiry is flagged for manual review by a care coordinator.

View more FAQs
896 hrs
Time identified
Process pain:8.6/10
Mapped by:8 Companies

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