Did you know? In a year, 15 billion faxes are sent out for referrals in the USA. Practices receive referrals through fax, online forms, direct messaging, email, virtual print, direct walk-ins, and other channels. A typical dental center is a high inbound referral setup. They need an effective referral management solution to manage the increasing inbound referral rates.
Existing Patient Referral Management Workflow in a Dental Center
A typical dental center or dental group is a high inbound patient referral setup. Dental centers receive volume of referrals weekly (ranging from 50 per week to even several hundred per week) depending on the number of patients visiting the center and number of clinics sending referrals to them. An effective referral management solution will help manage small or big volumes of referrals by reducing manual tasks and using automation and structure where possible.
Dental centers usually have a dedicated team of referral coordinators who receive, accept and process the referral requests. These referral coordinators manually key in the necessary details into an EMR/EHR system and create a referral. The time spent by referral coordinator in a completely manual process can be reduced by using technology. Productivity and efficiency is increased by introducing technology to aid the process. It results in piling up requests that are not yet processed. When the referral coordinator does not have the required information to process the referral, he has to contact the referring provider. This further incurs time and results in slow referral processing rate. This, in turn has a negative impact on patient experience. Hence, patient referral leakage also becomes imminent.
Consequences of a slow referral network
- The dental center loses its revenue when referrals are not processed in time.
- Providers stop referring the center thereby harming its reputation.
- Patients may have severe illness and may need immediate attention. The waiting time may affect their health.
Challenges faced by a Dental Center
- Referrals flow into the dental center through various channels like fax, online forms, direct messaging, email, virtual print, direct walk-ins, etc. A dental center has no specified source to receive referrals.
- The dental center receives numerous referrals which are difficult for them to process. This is because there is no single system to consolidate and manage referrals
- There is no tracking system to understand in which stage of a referral life cycle is any referral is in.
Let us review a typical referral process to elaborate the challenges faced by the dental centers.
- Patient visits the PCP – Andrews met with an accident recently. He met his PCP, Dr. John immediately as he was experiencing pain in his jaw. After examining him, Dr.John wanted him to consult a dentist. The doctor then initiated the referral.
- PCP initiates the referral – John created a referral in his EMR. He did not have time to do the insurance pre-authorization so he left it to Andrews. He then found a dentist and gave him referral information verbally. Now when he met the specialist, Andrews had to again elaborate his condition and problems to him. This is time-consuming for the specialist as he wastes time on the same information twice.
- Specialist requires more information – The specialist, Dr. James is a famous dentist in the locality. After receiving the referral, he schedules an appointment with Andrews. After the appointment, Dr. James wants more information about the patient’s history and diagnostic reports. Now, he has to wait for the PCP, Dr. John to send him the relevant information.
- No tracking system for referrals – As Dr. James is a famous dentist in the locality, he receives numerous referrals in a day. There is no tracking system for him to know how many referrals he received, how many were processed, in what status each referral is in, etc. So it is difficult for Dr. James to know understand the analytics of his specialty.
HealthViewX Patient Referral Management solution at your aid
Patient Referral Management is complicated not only by the different sources but also by trying to manage all the referrals manually. The current referral management is no way close to the increasing demands of the referral process. Its inability to communicate between the referring and the receiving ends makes it slow and non-feasible.
Considering the challenges faced by dental centers, an Electronic Referral Management Software can help them better. After the complete analysis of a dental center’s referral workflow, HealthViewX realized that the crucial part of the problem is the lack of a system to consolidate referrals. On further analysis of their process, HealthViewX Patient Referral Management solution introduced the following features to meet their requirements,
- Multi-Channel Referral Consolidation – Referrals flowing in through many channels are consolidated in a single interface. It enables easier monitoring and facilitates timely referral loop closure.
- Referral Tracking – HealthViewX gives a clear picture about how a referral has progressed with the help of a timeline view. Every referral has a status which conveys in which stage the referral is in. With the help of a customizable dashboard, the exact number of referrals waiting to be processed can be identified easily.
- New Referral Channel – HealthViewX Referral Management solution supports a new channel for sending and receiving referrals. This is called the desktop application. Sources like email, website, direct message, fax, etc are not secure and difficult to handle. On the other hand, desktop application is a secure source for sending and receiving referrals. Also documents can be attached and sent as a referral.
- Referral Data Consolidation – It has options for printing the consolidated data about the referrals and the referral history of any patient as a hard copy at any time in PDF/excel.
- Secure Data Management – HealthViewX Patient Referral Management is HIPAA compliant. It manages all patient-related documents securely.
- Referral Analytics – Helps in tracking the number of referrals and gives complete information about the referrals processed, missed, scheduled etc with the help of a Referral Data-centric Dashboard.
HealthViewX Patient Referral Management solution helps dental centers in managing their referral network and increasing their revenue. Are you a dental center looking to track your inbound referrals very effectively? To know about HealthViewX Patient Referral Management System in detail schedule a demo with our team.
Why is Patient Referral Management important for hospitals?
Patient begin a journey with the hospital when they are referred to that hospital to improve their health condition. Their expectation of the referral is usually high as they have sought another hospital for better experience and treatment. So hospitals must try to live up to the expectations of their patients. In order to manage huge volume of referrals, a hospital must have an effective Patient Referral Management System in place. This blog highlights challenges faced by operations manager, revenue cycle manager, healthcare IT department, patient referral coordinators and care providers (physicians and specialists) and how HealthViewX Patient Referral Management Software can help.
Challenges faced by physicians and specialists
Physicians and specialists play pivotal roles in the patient referral process. Physicians or PCPs hold the responsibility of initiating referrals. A patient visits the PCP and it is the discretion of the PCP to refer the patient to a specialist. What problems do physicians face in a referral process?
- Manual and time-consuming process – The process of creating a referral is too manual and time-consuming. In every stage of the referral, the physician has to put in a lot of effort. Here are few instances,
- The physician has to wait for the insurance pre-authorization process to be done
- Finding the right specialist takes a lot of effort from the physician’s side
- After sending the referral, the physician has to wait for referral updates from the specialist.
From a specialist’s perspective the referral process is cumbersome. A specialist faces the following challenges,
- Multiple referral channels – For the specialist/imaging center who receive referrals face more difficulties than the referring provider. The receive referrals through various channels like fax, email, direct message, website, user-filled forms, etc. Managing and tracking all of it manually is a tedious task. The chances of missing out on a referral are high.
- Poor communication framework – The existing referral process has no quick mode of communication to contact the PCP or referral coordinator for missing information. The specialist has to wait till he/she gets the necessary information before starting with the referral process.
Challenges faced by referral coordinators
After a referral request is initiated, then it is the job of the referral coordinator to create a referral. A referral faces the following challenges,
- Insurance pre-authorization – A referral coordinator has to consult the insurance company if the diagnosis prescribed meet the insurance requirements of the patient. This process takes time as the referral coordinator has to wait for the insurance company to respond.
- Finding the right specialist/imaging center – The next big step after insurance pre-authorization is finding the right specialist or imaging center for the patient. The referral coordinator has to consider many factors like the patient’s convenience, specialist’s availability, new specialists in the locality, etc. This is time-consuming as there will be many specialists and imaging centers. Narrowing down the search manually will be difficult for the referral coordinator.
- Handling multiple software – A referral coordinator has to handle an EHR, fax system, appointment scheduling software all at the same time. The coordinator has to
- Collect the patient information and demographics from the EHR
- Do the insurance pre-authorization
- Find the specialist
- Send out the referral as a hard-copy fax
Handling so many things at the same time is tedious for the referral coordinators
Challenges faced by an operations manager
- Patient Referral Leakage – An operations manager will be primarily worried about how many patients are referred out of the network. Patient referral leakage is a determining factor in a referral network. In many cases, the patients are referred out-of-network even when there are appropriate specialists within the network.
- Referral Analytics – As a large number of referrals flow in and out of the network, it is difficult to track the exact number. It is also tedious to track the number of referrals in various status and to close referral loops. The operations manager also needs to know how many referrals were sent or received, how many were processed, how many are yet to be processed, etc.
Challenges faced by a revenue cycle manager
- Patient no-show rates – After receiving the referral, the specialist/imaging center schedules appointments with the patient. In some cases, the patients are not notified clearly about the appointment. When patients do not show up, it is difficult for the specialist/imaging center to track. It results in revenue loss and patient dissatisfaction.
- Costly software – As mentioned earlier, a referral process needs an EMR/EHR, appointment scheduling software and a fax integration system. So many softwares for a single process is not efficient.
Challenges faced by an IT strategist
- Handling sensitive patient data – Patient data must be handled securely. Considering the current manual process, it is difficult to maintain data security.
How can HealthViewX solution add value to the process?
- Insurance pre-authorization process – HealthViewX automates the insurance pre-authorization process. The provider need not coordinate with the insurance company for prior authorization. The HealthViewX solution will do it for them. This reduces the manual effort of the referral coordinators.
- Intelligent Provider Match – The HealthViewX “Smart Search” feature makes it easy for the referring provider in finding the right provider. It has smart filters and search options that help in narrowing down the specialist based on the requirements. This saves a lot of time for the referral coordinators.
- Timeline View to track referrals – With the help of a referral status, the referring provider can get to know what stage the referral is. A timeline view shows a history of stages through which the referral has progressed. The chances of a referring provider missing out on referral updates are very less.
- Referral closure and feedback – The referring provider can close the referral when it gets completed. The receiving provider and the patient can give a feedback on the referral process to the referring provider. Thus the referring provider can make it easy for the other the next time.
- Multi-channel referral consolidation – The HealthViewX solution can capture fax, phone, email, online form referrals or any other referrals in a single interface. It makes it easy to monitor and manage all channels of referrals in a single queue.
- Patient coordination framework – After finding the receiving provider, the referral coordinator refers the patient. When the receiving provider receives the referral, the provider will get notified of the referral. Even the patient will be notified of the referral. The receiving provider can schedule appointments based on the patient’s comfort. This will cut down patient no-show rates.
- Referral Analytics – Helps in tracking the number of referrals and gives complete information about the referrals processed, missed, scheduled etc with the help of a Referral Data-centric Dashboard. It helps the operations manager in taking informed decisions.
- HIPAA compliance – The solution is completely HIPAA compliant which enables secure patient data exchange.
HealthViewX Patient Referral Management solution smooths the referral process and solves challenges faced by people in different designations in healthcare. Do you want to know more about HealthViewX HIPAA compliant Patient Referral Management solution? Schedule a demo with us.