A voluntary behavioral baseline for AI voice agents in B2B healthcare payer–provider calls — with an open cryptographic authorization layer (v2) in reference implementation.

Built by a former payer operations associate who saw the problem firsthand on live calls. Not a standard. Not a certification. An open, testable reference.

Website · Simulator · Spec · v2 Identity Layer · Discord

• Live API — Try It Now
• The Four Controls
• Five-Layer Trust Stack
• Regulatory Alignment
• Repository Structure
• Quick Start
• NHID-Auth v2 — Cryptographic Agent Identity
• Contributing & Pilot Partners

The conformance API is live. No signup, no key required for the demo and vendor adapter routes.

# Test a non-compliant VAPI call (PHI requested before identity disclosure → IDG-01 + PDX-01 FAIL)
curl -s -X POST https://dc2ipcqs7k.execute-api.us-east-2.amazonaws.com/prod/v1/adapters/vapi/check \
  -H "Content-Type: application/json" \
  -d @tests/demo_scenarios/vapi_noncompliant.json | python3 -m json.tool

{
  "conformant": false,
  "action": "DENY_DATA",
  "violations": [
    { "rule_id": "IDG-01", "severity": "critical" },
    { "rule_id": "PDX-01", "severity": "critical" }
  ]
}

New here? Start with the 5-minute quickstart, then the staged v2 integration guide (Tier 0: 15 min → Tier 2: 1 day).

⬆ Back to top

Plus one supplemental control, ATR-01 (Audit Trail Requirement) — every call must produce a machine-readable audit trace.

18-case CTS suite · same inputs → identical trace output · 270 passing in the Python test suite (18 skipped without a running server) + 66 passing in the TypeScript middleware

⬆ Back to top

Full technical architecture →

⬆ Back to top

Full regulatory alignment matrix →

⬆ Back to top

NHID-Clinical/
├── schema/          # Canonical event schema (JSON Schema Draft 2020-12)
├── src/             # Policy engine + cryptographic identity layer (pure Python)
├── tests/           # Conformance suite (YAML) + failure harness (pytest) + trace generator
│   └── demo_scenarios/  # Pre-built VAPI + Twilio test payloads
├── traces/          # 10 pre-generated failure traces
├── adapters/        # Vendor adapters — VAPI, Twilio, Vonage, Retell, Amazon Connect
├── functions/       # AWS Lambda handler
├── vendor/          # Vendor compliance dashboard (static HTML, no build step)
├── tools/           # Pilot report generator
├── docs/            # 5-minute quickstart, staged v2 integration guide
├── NHIDClinical.psm1  # PowerShell module for payer teams
└── specs/           # PDF artifacts — Core Specification + Operational Blueprint

⬆ Back to top

git clone https://github.com/NHID-Clinical/NHID-Clinical.git
cd NHID-Clinical
pip install -r requirements.txt
python -m pytest tests/ -v

Expected output: 270 passing in ~1.4s (requires cryptography package for identity tests; ~18 skip when no server is running).

⬆ Back to top

v1.3 verifies disclosure behavior. v2 verifies authorization: provider-signed agent credentials with NPI binding, scoped delegation chains (max 3 hops), per-agent revocation, and call-SID nonce binding. Reference implementation in src/agent_identity.py (26 tests). Released June 2026 under CC BY 4.0.

python -m pytest tests/test_identity.py -v
python examples/issue_and_verify.py

Details →

⬆ Back to top

We are actively seeking payer and provider organizations to run a 90-day shadow evaluation — no vendor changes required.

Become a Pilot Partner →

Community · Discord · contact@nhid-clinical.org

⬆ Back to top