Monthly Archives: December 2018

Refer Your Patients Through HealthViewX Referral Management Software

Existing Referral Management Workflow

When primary care physicians feel that their patients need advanced treatment or diagnosis, they refer them to specialists or imaging centers. Let us consider a typical example were in a referral takes place,

Dr.James runs a dentistry specialty center. This specialty clinic has certain clinics who refer most of their referrals to them. One such clinics is the clinic run by Dr.Anderson, a PCP.

  1. Patient visits Dr.Anderson –  Patient Mark met with a minor accident that caused him head injury. He visits Dr.Anderson who is his PCP. After examining him, Dr.Anderson wanted a specialist’s advice on this.
  2. Dr.Anderson does the insurance pre-authorization – Dr.Anderson does not have a dedicated team for doing the insurance pre-authorization. He spends 15 minutes per patient on the pre-authorization process. This implies that if he does pre-auth for 8 patients a day, he is spending two hours a day on this. This is time-consuming considering his busy schedule.
  3. Dr.Anderson initiates the referral – He usually sends dentistry related referrals to Dr. James. Though it is a trusted specialist center, Dr.Anderson is not happy with the way he has to send referrals to Dr.James. He has to fill out a form every time he sends referrals to this specialist. He downloads the form from the specialty clinic’s website and fills in the necessary details and diagnosis. Then he sends the faxes the referral to the specialty clinic.
  4. After sending the referral – The specialty receives the referral from Dr.Anderson but it doesn’t notify him about the same. Now, Dr.Anderson does not receive any updates about the referral’s the progress from Dr.James or the patient Mark. Though Dr.Anderson has received positive feedback from the patients who he had referred previously to Dr.James, he is still worried if Mark was taken care of.

In this case, the referral workflow lacks standard referral channels and communication methods. It makes the referral experience bitter for the referring provider.

New referral channels for a better experience with referrals

On detailed analysis of a dental specialty’s current process, we realized that the crucial part of the problem is the channel through which the referrals are being received. Our HealthViewX Referral Management solution supports two new sources for sending or receiving referrals. They are the desktop direct and the type-enable pdf options. The best part is that it is not necessary for the referring provider to use our platform directly.

Desktop Direct is a secure platform that enables providers to share patient referral information from their desktop. It is a light-weighted healthcare application white-labelled for the practice with the ability to send and track patient referrals from a referring provider’s system. It supports sending out medical referrals in electronic formats and tracking the referrals. The receiving provider can upload the test results or relevant documents for the benefit of the referring provider. The referring provider can download the patient medical referral data securely for future reference.

In case of a type-enabled pdf, we send the referral form as a pdf to those clinics who refer to the specialty regularly. We send via email or give them a plugin. The form will be easy to fill out and with a click, the referring provider can send it to the receiving provider.

HealthViewX Referral Management features that benefit the receiving provider

Though it is not necessary for the referring provider to use our platform, the receiving provider must have the HealthViewX platform. It has the following features that make the referral process easier for the receiving provider as well.

  • Single Referral Workflow Queue Consolidation – It collects Fax, Phone, Email, Website form and all possible channel referrals. It helps in managing them better in a single interface.
  • Timeline View – Both the specialist and the PCP can view the timeline data of the patient in which the referral history is present. Documents and notes can be attached anytime for one another’s reference.
  • To and fro Communication – At any time of the referral process, the PCP and the center can communicate with the help of the inbuilt secure messaging and voice call applications.
  • 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 application simplifies the referral process for the referring providers. It also provides a better workflow for the receiving providers. This, in turn, increases patient satisfaction and revenue. To know more about HealthViewX solution, schedule a demo with us. Our patient referral management experts will guide you through our HIPAA-compliant solution.

A Leading FQHC In California Chooses HealthViewX To Manage Their End-To-End Referral Process

About the Federally Qualified Health Center

Federally Qualified Health Center (FQHC) in the United States is a non-profit entity comprising of clinical care providers, that operate at comprehensive federal standards. The care providers in FQHC are a part of the country’s health care safety net, which is defined as a group of health centers, hospitals, and providers who are willing to provide services to the nation’s needy crowd, thus ensuring that comprehensive care is available to all, regardless of income or insurance status. This client is the health care safety net for their county’s poor and uninsured people. The FQHC gives the people access to high-quality health services that they needed and deserved. They are key regional health providers who treats more than 65,000 patients annually.

Challenges in the existing referral workflow of HealthViewX Federally Qualified Health Center client

The following are the major problems our Federally Qualified Health Center client wanted a solution for. Let us consider the challenges with a typical referral scenario to understand it better.

  1. Insurance pre-authorization – The physician must check the pre-authorization requirements, health plans, etc. He must retrieve patient-specific data like the history of medications, medical diagnosis and insurance coverage. The physician must then send it to the insurance company so that they can validate the same. This client did not a dedicated team or software to do insurance pre-authorization which increased their burden.
  2. Tracking the referral – Specialists are usually busy. They do not have the time to inform physician’s about the progress of referrals. So the physicians are unable to track referrals. They get no information about appointments, referral loop closure or feedback from specialists or patients.

How HealthViewX features helped this FQHC client resolve their challenges

Considering the existing workflow of the FQHC, their major problems are insurance pre-authorization and referral tracking. So how can HealthViewX Patient Referral Management solution help in solving these problems?

The following features made the pre-authorization  and referral communication easier for this FQHC client,

  1. EMR/EHR integration – Our System integrates directly with electronic health records (EHRs). This enables healthcare professionals to easily obtain prior authorizations in real time at the point of care. It also eliminates time-consuming paper forms, faxes, and phone calls.
  2. Insurance pre-authorization automation –  There are two ways in which HealthViewX solution automates the insurance pre-authorization process. The first one is the api-based method. Through this, we retrieve information regarding the forms and communicate information back and forth between the FQHC and the insurance company. The second one is the form automation method.  Through this, we get all payer-specific form, fill in the necessary information and send it to the insurance company via efax
  3. To and fro Communication – At any time of the referral process, the PCP and the center can communicate with the help of the inbuilt secure messaging and voice call applications. By this, the physicians can get referral updates easily.

Useful HealthViewX Patient Referral Management Solution features

Leading FQHC in California has chosen HealthViewX due to the industry-leading patient referral management features. FQHCs across USA can benefit from Referral Management Software depending on their patient referral workflow,

  • Intelligent Provider Match
  • HIPAA compliant data security
  • Referral history
  • Referral loop closure

HealthViewX Patient Referral Management software has provided the best use cases for the major challenges faced by the FQHC. Are you a Federally Qualified Health Center missing out on your referral updates? Schedule a demo with us to know more about our solution.