Day-of-surgery readiness check

How do we check the day before surgery that the consent, the clearance, the labs, the authorization and the payment are in place, and route each gap to the right team before the case starts?

Run the readiness check as a gate with an owner for every gap. The day before each case, Callvu classifies the case's requirements (the signed surgical and anesthesia consents, the medical clearance, the pre-anesthesia assessment, the labs and tests by the anesthesia plan with their validity, the imaging, the implant and the blood availability, the payer authorization with its number and dates, the pre-service estimate and payment, the instructions acknowledged, the escort) and reads each from the EHR, the billing system and the authorization process, chases the gaps the patient or an outside office can still close (a signature, a result, a confirmation), routes each remaining gap to the team that owns it in the Decision Desk (the surgeon's office, anesthesia, the laboratory, the authorization team, patient access) with only the allowed outcomes, and marks the case ready, ready with conditions, or at risk, with the operating room schedule and the surgeon seeing it.

In scopeComplex: multi-party handoffsCallvu moves: classify, chase and verify, decide

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Last updated November 7, 2026.

The problem today

The case was cancelled at 7am for an authorization that had expired on Friday, which three systems knew and no one looked at.

Today, without Callvu

The morning of surgery is where every upstream gap lands: an unsigned consent, a clearance with a condition, a potassium result from a test that was never drawn, an authorization that expired or was for a different code, a deposit never collected, no escort. Each lives in a different system and belongs to a different team, and the pre-operative nurse discovers them one at a time with the patient on the gurney.

The universal protocol and the accreditation standards require the pre-procedure verification of the consent, the history and physical, the results and the implants; the payer's authorization must match the procedure and the date; the hospital's financial policy sets the pre-service collection. The readiness check is a read of each requirement against its source, and a gap is a case for the team that owns it, with the surgery time as the deadline.

A gap found the day before has an owner and a fix; one found at 7am has a cancellation.

How it runs

From the requestto the system of record.

The day-before window opens for each scheduled case (and again on the morning for the time-critical items). Callvu classifies the case's requirements and runs the check.

Patient: Closes the gaps only they can (a signature, an escort confirmation, a payment) on their phone.
Owning teams: The surgeon's office, anesthesia, the laboratory, the authorization team and patient access decide their gaps in the Decision Desk.
Pre-operative nurse and operating room scheduler: See the readiness status and act on at-risk cases.
Callvu: Classifies the requirements, reads each source, chases what the patient can close, routes each gap and writes the status.

Classify the requirements
The procedure, the anesthesia plan, the surgeon's and the facility's protocols, the patient's risk category and the payer classify the case's requirements: the surgical and the anesthesia consents signed, the history and physical and the clearance within validity, the pre-anesthesia assessment reviewed, the labs and tests the plan requires with their validity periods, the imaging and the implants available, the blood type and screen where required, the authorization with the right code, dates and facility, the estimate delivered and the pre-service payment under the financial policy, the instructions acknowledged, the escort named.
Read and chase
Each requirement is read from its source (the EHR for consents, assessments, results and orders; the authorization process for the payer's decision; the billing system for the estimate and the payment; the instructions process for the acknowledgments); a gap the patient can close is chased on their phone (an unsigned consent through the consent process, an escort's name and number, a payment on a secure screen), and a result pending from an outside laboratory is chased from it.
Chase and verify, then decide by owner
Each remaining gap is routed to the team that owns it in the Decision Desk with the case and the surgery time: an unsigned consent to the surgeon's office, a clearance condition or a missing assessment to anesthesia, a missing or expired result to the laboratory or the pre-operative clinic, an authorization that is missing, expired or for the wrong code to the authorization team, an uncollected deposit to patient access; each team has only the allowed outcomes (close the gap, waive under the protocol with the reason recorded, or declare the case at risk).
Write back
The case's readiness status (ready, ready with conditions, at risk with the open gaps and their owners) is written to the EHR and the operating room schedule, the surgeon and the scheduler see it, the morning check re-reads the time-critical items (the fasting confirmation, the escort, the vitals), and the record of the verification is kept for the universal protocol.

Where it ends: Every requirement was read from its source the day before, every gap had an owner and a decision before the morning, and the operating room schedule showed which cases were ready and which were at risk with time to act. The Decision Trace shows the requirements, each source read and each team's decision; the Audit Trace shows the reads, the chases and the status writes with time.

Runtime enforcement

What is enforcedwhile the work runs.

The regulations preloaded in Callvu Studio and the bank's own policies, applied as steps that run, not lines in a binder. A step that breaks a rule does not run, so a completed run was compliant.

Regulations

HIPAA Privacy Rule, uses for treatment, payment and operations (45 CFR 164.506) and the minimum necessary standard (45 CFR 164.502(b)): The readiness check reads clinical, authorization and financial data across systems for the patient's treatment and the facility's operations, with each team seeing the elements its role needs; the verification record is part of the medical record.
Universal Protocol and pre-procedure verification (the Joint Commission Universal Protocol UP.01.01.01 and the provision of care standards; CMS Conditions of Participation for surgical services, 42 CFR 482.51, and the history and physical requirement, 42 CFR 482.22): Before the procedure the facility must verify the correct patient, procedure and site, and the availability of the consent, the history and physical within thirty days with the update, the relevant results and images, and any implants and blood products; the readiness check evidences the verification the day before so the morning briefing confirms rather than discovers.
Payer authorization rules and the facility's financial policy (the plan's prior authorization requirements; IRS 501(r) and the hospital's pre-service collection policy): The authorization must match the procedure code, the facility, the surgeon and the date or the claim denies; the financial policy sets the pre-service estimate and deposit, applied with the financial assistance screening so a patient is never turned away in breach of the assistance policy.

Company policies

The check runs the day before every case; nothing waits for the morning briefing to be discovered.
Every gap has an owning team with a deadline and only the allowed outcomes; a waiver carries its reason.
The patient closes only the gaps that are theirs, on their phone.
The EHR and the operating room schedule hold the readiness status and the verification record.

Controls

Requirement classification by procedure, plan and payer.
Reads from the EHR, the authorization process and the billing system.
Patient chases for signatures, escort and payment.
Gap routing to owning teams in the Decision Desk.
Readiness status with conditions and at-risk flags.
Morning re-check of time-critical items.

Clocks and deadlines

Day-before check: Runs at the department's hour the day before, with the surgery time as every gap's deadline.
Result validity: Each lab or test checked against its validity period for the anesthesia plan.
Morning re-check: The fasting confirmation, the escort and the vitals re-read on the day.

Documents and checks

The requirements list by case
Each requirement's source read and status
The chases and each team's decision
The readiness status and the verification record

In the Decision Trace

The requirements and their basis.
Each gap's owner and decision.
Any waiver and its reason.

In the Audit Trace

Each read with source and time.
Each chase and decision with time.
The status writes and the morning re-check.

The handoff

Between the front doorand the back office.

The front door

The patient on their phone for the gaps that are theirs; otherwise none, the check reads the systems.

The back office

Each owning team decides its own gaps with the surgery time in view; the nurse and the scheduler see the status, not the hunt.

The Decision Desk

Each gap goes to its owning team (the surgeon's office, anesthesia, the laboratory, the authorization team, patient access) in the Decision Desk with the case and the surgery time, and only close the gap, waive with the reason, or declare the case at risk.

Proof

In scope.Proof at scale, not one process at a time.

The kind of process Callvu runs in production for customers in this industry. Ask for a reference on this exact process. The results below are the industry's published proof; each claim code links to its record on agents.callvu.com.

23 hospitals in the Ministry of Health network run on Callvu.

Across Callvu customers

More than 1,000 processes are live across Callvu customers.

Across Callvu customers

Questions

What buyers ask next,answered plainly.

What is checked?

The consents, the clearance and the history and physical within validity, the anesthesia assessment, the labs and tests with their validity, the imaging, implants and blood, the authorization's code and dates, the estimate and payment, the instructions acknowledged and the escort, each read from its source.

Who fixes a gap?

The team that owns it, in the Decision Desk, with the surgery time as the deadline: the surgeon's office for consent, anesthesia for a clearance condition, the laboratory for a result, the authorization team for the payer, patient access for the deposit.

What does the surgeon see?

Each case marked ready, ready with conditions, or at risk with the open gaps and their owners, on the operating room schedule the day before.

Related processes

Pre-op instructions and acknowledgment Medical clearance from the primary care physician Pre-anesthesia assessment Surgical informed consent, chained with anesthesia consent Try it in the sandbox All healthcare processes

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