Tag Archives: healthcare

How Can Price Transparency Impact The Healthcare Industry?

Patient financial responsibility is the greatest challenge of healthcare industry. For a long time, healthcare experts have argued that price transparency will help patients in making informed healthcare decisions thereby decreasing healthcare costs.

In August 2018, CMS stated in its updates to the Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH PPS) final rules that price transparency will become a nationwide industry standard.

With effect from January 1, 2019, hospitals across the country are responsible for full price transparency. As per the IPPS and LTCH PPS rules, hospitals must list their prices online in a “machine-readable format.”

CMS approach to enforcing price transparency

Previously, hospitals were required to make their prices publicly available, but not necessarily in a digital format. In the new rule, CMS has mandated that these new price transparency resources be in a machine-readable format. CMS analyzed public comments on the most efficient way to achieve this. Finally, CMS called on all hospitals to list their chargemaster prices on a publicly-available Excel spreadsheet. The searchable spreadsheet will make it easier for patients to use.

Hiccups in the existing approach by CMS

Many questions have been raised about this approach.

  • Critics claim that charge master prices are not ideal for patients. Between insurance, subsidies, and other payment design, patients usually pay less than chargemaster price.
  • The feasibility of an Excel spreadsheet having all prices is a big question.
  • As more organizations publish their price transparency lists, more difficulties may come to light.

How can price transparency help patients?

  • Digital price transparency will enable patients to more easily access this information.
  • Price transparency will enable patients to make more informed decisions about care access that minimize their out-of-pocket costs and total expenditures borne by Medicare and Medicaid.
  • Increased price transparency will improve the patient experience of care.
  • Although price transparency itself cannot lower healthcare costs, but it may create market pressure that in turn lowers patient costs.
  • Additionally, price transparency will allow patients to choose the best care option for their needs.

The healthcare industry is still debating about the efficacy of price transparency. Healthcare price transparency tools have already made their mark in the healthcare industry. Do such tools improve patient experiences with healthcare or cut costs? How can organizations reconfigure these tools to increase its effectiveness?

Can price transparency reduce healthcare costs?

According to a 2016 study published in Health Affairs, it was found that price transparency tool actually increased out-of-pocket outpatient spending by about $59 per patient. The researchers suggested that it must must have been due to low patient awareness or perceived need of the tool.

Moreover, cost compare tools did not show many meaningful areas for cost savings.

Other studies have also shown similar results. A 2017 report by the American Journal of Managed Care found that though patients liked the idea of a cost comparison tool, they saw little use of the tool. They either forgot to use the tool before seeking care or did not see any use because they were already beyond their deductible or saw consistent copayments at their doctor’s office.It also touched on the idea of patient loyalty. Although patients could use price transparency tools to find a less expensive care option of equal quality, a sense of loyalty kept them going to their current clinicians.

Payers who offer price transparency tools have also had little luck with the tools. A 2017 report published by Health Affairs found that although scanning a cost compare website could result in 14% cost cuts for imaging services, only 1% of patients actually use the tool, making it of little use.

What do industry professionals say?

Although price transparency tools are not currently impacting the rising healthcare costs, these tools still have the potential to reduce spending and improve patient experience.

If properly utilized, cost compare technology should help patients cut their own healthcare spending because they know the lower-cost providers to visit. Patients with access to a price transparency tool have the opportunity to compare cost and quality and make their preferred treatment selection based on that data. Ideally, this will lead patients to a lower-cost option.

Clinics have little incentive to lower their costs when patients do not know how much they’ll pay before they receive the service. But if all clinics knew patients were visiting a high-quality facility with substantially lower costs, area competitors could be forced to change their prices, as well.

How can organizations make price transparency work?

Making price transparency tools that are attractive and usable for patients will be critical for delivering on the promise of cost compare. Simply offering a price transparency tool will not lower costs. Patients must actually use these systems to select lower-cost care.

As the healthcare industry continues to place more financial burden on patients, it will need to adopt strategies that help patients. High copay and high-deductible health plans have put patients in the role of the healthcare consumer. Price transparency tools are a key retail-style engagement strategy that will help consumers make better decisions about where to access care.

But in order to make those price transparency tools effective, industry leaders must keep the patient at the center of their design. Making a usable cost compare tool that uses simple language and factors in metrics that are important to patients will be integral going forward.

 

Reference

https://patientengagementhit.com/news/myhealthedata-patients-over-paperwork-key-in-cms-final-rules

https://jamanetwork.com/journals/jama/fullarticle/2518264

https://patientengagementhit.com/news/price-transparency-tools-receive-tepid-patient-reactions

https://patientengagementhit.com/news/4-patient-engagement-strategies-to-improve-patient-retention

https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2016.1636

Why do Federally Qualified Health Centers need a Referral Management Software In Addition To An EMR?

Patient Referral Management is crucial for Federally Qualified Health Centers (FQHCs). With the advent of the Patient Protection and Affordable Healthcare Act, Electronic Health Records have been widely adopted across many FQHCs. There are many benefits to EHRs like improved,

  • Accessibility to patient data
  • Charge capture
  • Preventative health

Let us look into each of them in detail to understand an EMR/EHR implementation better.

Pros of EHR/EMR

1. Improved data accessibility

Before EHRs, access to medical charts required a fair amount of physical labor. For example, every time a patient visits the physician’s clinic or hospital, physician physically pulls their file from a storage space. As a result of this back and forth exchange, there was a greater chance of human error and charts would sometimes be missing information or be chronologically out-of-order.

EHRs, on the other hand, have eliminated the physical transporting, sifting and filing charts, making data available at all times. Additionally, for systems that allow remote access to charts, clinicians can even be offsite and still securely access patient files.

2. Computerized physician order entry

CPOE allows physicians to place lab and imaging orders, prescriptions and other notes electronically. This reduces the error of handwritten orders and allows the patient’s other physicians within the same network access to the order.

3.Preventative health

EHRs allow prompts for preventative health screenings. During routine doctor or urgent care visits, the physician has access to preventive health records conveniently in one place. If the patient is due for a cancer screening (such as mammogram or colonoscopy), or blood pressure testing, the referral coordinator can easily look this up via the EHR system and schedule an appointment for the patient.

4. Ease sign off for PAs and NPs

While this varies from state-to-state by law, physician assistants and nurse practitioners are typically required to have their notes approved and signed off on by their supervising physician. EHRs allow the revision and cosigning of notes to happen electronically as opposed to physically moving and signing the paper.

5. e-messaging between providers

As any referral coordinator can attest referral information, telephone tag between providers can be common and is a big time-waster. With EHR software, physicians can e-message across practices. One situation that benefits in particular from e-messaging is referrals. Rather than playing telephone tag to get an appointment scheduled, the physician electronically sends a message to schedule the appointment.

How can a Patient Referral Management Referral Management work in cohesion with an EMR/EHR system?

FQHCs prefer working with EMR/EHR systems because they are comfortable with it. So they do not wish to move out their EHR/EMR system. 

How great it would be if a Patient Referral Management software could integrate seamlessly with an EMR/EHR system? It can help in ensuring end-to-end Patient Referral Management without disturbing the existing system.

An EHR/EMR system has many advantages but when it is complemented with a Referral Management software practices can experience many more benefits.

HealthViewX Patient Referral Management solution provides easy steps to integrate with a practice’s EMR/EHR system. The patient demographics, diagnostic reports, test results or any sensitive information can be transferred safely. The solution is HIPAA-compliant with complete data security. It has the following features,

  1. Outbound Referrals – HealthViewX Referral Management Solution can integrate with both the receiving and referring end. For inbound referrals, it helps in channelizing various sources into one single queue. In case of outbound referrals, it facilitates integration with the existing system to read the patient data and send out referrals.
  2. Referral Timeline – In HealthViewX Referral Management System, any referral has a timeline, to capture and notify the progress of the referral to all the stakeholders. A referral will be mapped to a status which helps in tracking it better. For e.g. – If a patient does not show up for the appointment, the status of the referral can be changed to no-show and an appropriate reason can also be given. With the help of a referral timeline, the providers can always be aware of what is going on with the referral.
  3. Workflow and Task Management – A workflow can be defined on how the referral flow must be(business rules). Providers can create tasks to manage referrals by assigning it to the respective person.
  4. Improved communication – HealthViewX Referral Management Solution supports messaging and calling features for the referring and the receiving providers to stay connected.
  5. Data Management – The solution is HIPAA compliant and enables secure data exchange of all patient-related documents.
  6. Seamless Integration – The solution can seamlessly integrate with any EMR/EHR/RIS or Third Party application thus providing minimal disruption in the existing referral flow.
  7. Referral History Consolidation – The consolidated data regarding the referrals and the referral history of any patient can be printed as a hard copy at any time in pdf/excel.
  8. Smart Search – HealthViewX Referral Management solution has a smart search facility that helps in finding the right provider for the treatment required.
  9. Referral Data Analytics – Referral data-centric dashboard gives complete data regarding the number of referrals flowing out, the number of referrals in various status, patient follow-ups, etc.

HealthViewX Referral Management solution helps in building a secure referral network in no time. Our expert team will guide you in changing to a Patient Referral Management Software with minimal effort. Schedule a demo with us to know more about our solution.

 

 

Reference

University of California—Davis. “UC Davis study finds e-medical records have varying effects on productivity.” Dec. 2010. http://www.news.ucdavis.edu/search/news_detail.lasso?id=966

How Can The Healthcare Industry Equip Their Senior Patients For Chronic Care Management?

Healthcare organizations and chronic illness

By 2029, estimates show that senior patients will make up 20% of the population and a considerable share of healthcare spending. As it stands now, senior patients and patients with chronic illness make up to 5% of the population but nearly 50% of healthcare spending. How can healthcare organizations cap these rising costs.

According to a report from BDO Center for Healthcare Excellence & Innovation, healthcare organizations are taking more responsibility when it comes to older adult care and chronic care management,

From NEJM Catalyst survey, it was found that healthcare organizations are looking into

  • Home health services
  • Strong chronic disease plans
  • Health IT

to address the needs of a growing aging population.

How can healthcare organizations achieve patient-centric and value-based care?

As mentioned earlier, healthcare organizations are looking into home health services and care plans to treat patients with chronic diseases.

Home healthcare services – Home healthcare is a wide range of health care services that can be given in your home for an illness or injury. Home health care is usually less expensive, more convenient, and just as effective as care you get in a hospital or skilled nursing facility. Examples of home health services include:

  • Wound care for pressure sores or a surgical wound
  • Patient and caregiver education
  • Intravenous or nutrition therapy
  • Injections
  • Monitoring serious illness and unstable health status

In general, the goal of home health care is to treat an illness or injury. Home health care helps you:

  • Get better
  • Regain your independence
  • Become as self-sufficient as possible
  • Maintain your current condition or level of function
  • Slow decline

Strong chronic disease plans – Patients with one or more chronic diseases need doctor’s attention almost every day. The physicians create care plans for such patients with vitals, measurements, activities, pain, etc that need to be monitored. This will help in keeping chronic patients healthy if they follow the care plan strictly.

HealthViewX Care Management and Chronic Care Management solution to ease the process for healthcare organizations

Information technology helps in making the process simpler for healthcare organizations by reducing their time and effort. HealthViewx software provides Care Management and Chronic Care Management solutions which help in providing home health services and also care plans for chronic patients.

HealthViewX Care Management solution supports the following features,

  • Care plans to enable remote care – A provider can create a care plan for a patient depending on the vitals, treatments, measurements, etc that need to be tracked. The patient-centric application helps in logging data for the vitals specified in the care plan. If needed the care plan can also be printed.
  • Customizable dashboards to suit the need – Dashboards comprising of graphs and tables show a comprehensive data of the number of patients in different care plans depending on the patient diagnosis.
  • Scheduler to keep track of the appointments – An inbuilt scheduler keeps track of the appointments and sends timely reminders to both the patient and the provider. The chances of missing out an appointment are very less.
  • Audio and video calling features – HealthViewX Care Management solution support inbuilt audio and video calling features which help in connecting with the patients for follow-ups.
  • Patient-reported data – Patients can record data for all attributes in the care plan. Summary graphs and table data helps the providers in monitoring the patient vitals. The patient records can be anytime printed in pdf or excel report form.
  • Health device integration – HealthViewX Care Management solution can integrate with any wearable device like Fitbit, apple watch, etc. Hence the patients need not waste time in logging data in the application if they are already using wearables.

HealthViewX Chronic Care Management solution supports the following features,

  • Automated call log feature – After a call, care plan creation or any action related to CCM health services, the system automatically adds call logs. It reduces the physician’s manual effort is logging the call logs.
  • Preventive Care plans – HealthViewX solution supports care plans for the Chronic Care Management service for a patient. The physician can create a care plan depending on the patient’s health report. It helps in monitoring the patient’s vitals.
  • Chronic Care Management Analytics – Dashboards with intuitive charts and tables give complete analytics of the Chronic Care Management services. It provides a clear picture of the revenue perspective.
  • Consolidated Report – The physician can generate a consolidated report of the Chronic Care Management services given for a particular period. This makes it easy for the billing practitioner for getting the Medicare reimbursements.
  • HIPAA compliance – HealthViewX Chronic Care Management is HIPAA compliant. It facilitates secure data exchange. The solution manages all patient-related documents securely.

HealthViewX Care Management and Chronic Care Management solutions have features that suit healthcare organizations best. To know more about our solutions, schedule a demo with us.

 

Reference

https://www.bdo.com/getattachment/4d33f6c8-6d21-41b1-bbc6-aac62f4a70fd/attachment.aspx?HC_Eldercare-Study_brochure_2018_WEB-(1).pdf=&utm_source=Media&utm_campaign=Candid%20Conversations%20on%20Elder%20Care

How valuable is a Patient Referral Management Software To Primary Care Physicians?

When PCPs send a referral to a specialist, they expect that specialists will let them know when their patients received care. Many times it doesn’t happen as expected. The hospital may be too busy to share information. In other cases, the hospital may have faxed a notification to a patient’s primary care physician (PCP). But, for one reason or another like coordination issues, busy schedule, the physician practice may never have received it.

There are many such problems as the above PCPs deal with every day. Let us read through a few in detail.

  1. Insurance pre-authorization – The time a PCP invests on the process of insurance pre-authorization is more. Waiting for the insurance to respond is neither good for the PCP, not the patient.
  2. Finding the right specialist/imaging center – The number of imaging centers and specialist practices is increasing day-by-day. It takes a lot of time and effort for the referral coordinator to narrow down the referral coordinator’s search and find the right one.
  3. Time Spent – As the referrals are handled manually, a referring coordinator spends about half-an-hour to one-hour for a creating referral on an average and even more time in following up the same.
  4. No Updates –  After a referral is sent, both the referring and the receiving providers get busy. It is not possible for both of them to be updated on the referral progress. So the specialist/imaging center and the patient fail to update the clinic on the progress of the referral. This results in open referral loops.

Manage your patient referrals better with the HealthViewX solution

Fortunately, many PCPs are realizing the need for a better way to process and manage referrals securely. This is when they feel an automated Patient Referral Management System can help.

HealthViewX Patient Referral Management solution enables creating a referral in three simple steps thus providing a successful referral program. After the referral is created, it can be tracked with help of the status. Both the referring and receiving providers will be notified of the appointments, test results, treatment recommendations, etc. HealthViewX can integrate with EMR/EHR and can also coordinate between the referring and the receiving sides. Any referral has a timeline view which is common to both the receiving and the referring providers. In the timeline view, history of the referral can be seen for eg: notes related to the patient’s health, previous status of the referral, etc. Documents attachment and status change can also be done at any time of the referral process. HealthViewX Patient Referral Management solution can always keep you updated on the progress of the referral thus simplifying the referral process and helps in closing the referral loop.

How has HealthViewX added value to PCPs’ patient referral problems?

1) Automating the insurance pre-authorization process

HealthViewX platform has a payer management module that maintains and manages

  • different payer details
  • their modes of prior authorization
  • direct authorization procedures
  • payer forms
  • online portal links

With this information already present, it provides the referral coordinator the capability to automate

  • prior authorization submission
  • status checks coupled
  • fax integration

It simplifies the process of insurance pre-authorization. The referral coordinator need not waste time on the process anymore.

2) Intelligent Provider Match

Our “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.

3) Establishing best practices

After using our HealthViewX Patient Referral Management System, physicians were automatically alerted to

  • Appointments
  • Referral status
  • Patient diagnostic reports
  • Referral completion

As a result, we can cut down on miscommunications and bridge the gaps between the specialist and the physician community. The system also assembles a patient encounter record from the EMR/EHR and pushes it directly to the physician.

4) Forming a close-knit of trusted referral receiving centers

Our system helps in strengthening ties with the medical community. From a history referral experiences the PCPs can from a close-knit of referral receiving providers. Physicians can refer now patients to hospitals they can rely on.

HealthViewX Patient Referral Management solution helps the PCPs in handling and managing their referrals. Are you a PCP looking for an end-to-end referral management solution? Schedule a demo with us. Our patient referral management experts will guide you through our HIPAA compliant solution.

Why Is HealthViewX The Next-generation Software In Patient Referral Management

What is Patient Referral Management?

When patients need advanced treatment or additional diagnosis that is not available within the practice, physicians refer them to a specialist/imaging center. The process of managing all the patient referrals that are received or sent is called patient referral management. It is a laborious process for FQHCs who refer patients to other specialists or imaging centers.

Challenges faced by FQHCs

One of our established clients based out of California is an FQHC who faced the following challenges in their patient referral network.

1. No single system for Referral Coordinators

The PCPs can create referrals on their EMRs. However, the referrals coordinators have to extract the referral lists that have been tasked on to their workgroup. They must manually pull down respective documents from patient chart to get the referral packet ready for Insurance pre-authorization. Then the referral coordinators must manually bundle the referrals and send those to the insurance company via fax. Post receipt of pre-auth acceptance, they have to manually track the rest of the activities. They have to communicate and coordinate with the specialist and patient, etc thus driving the referral to closure. In this workflow-intense process, the referral coordinators must hop through multiple systems like EMR, eFax, and spreadsheets etc. There is no system for the Referral coordinators to maintain and track the further status of the referral through the rest of its life cycle.

2. Cumbersome Insurance Pre-Authorization

Our FQHC client sends about 600 plus authorization requests per day to 15 plus different payers. Every authorization or referral packet has 14 plus pages. Some payers have their own physical forms that have to be manually filled in. These forms must be attached to the rest of the patient documents pulled from the EMR manually. Some payers have online portals for the above process. Considering the volume of authorization requests sent every day, it is not advisable to rely on a fully manual function. It makes the process cumbersome and prone to errors.

3. Specialist & Patient Referral Communication

From their EMR, referral order letters go to the patient. But the EMR has issues with its patient referral order template. Hence the referral coordinators have to manually design the template using MS Word and send it out. Specialist cover letters and reminder notifications in the EMR do not meet the requirements of the referral coordinators. They wish to customize and automate it.

4. Referral loop closure

Following up with the Specialists, receiving the reports back from the Specialist, and attaching it back against the patient chart in the EMR are completely manual time-consuming. Relying on only Fax & phone based communication for the same makes it cumbersome to manage as it has no effective means for tracking

5. Meeting Meaningful Use (MU) requirements with the EMR Share feature

Though the EMR SHARE’s main purpose was to help providers meet the MU requirements. In order to meet MU, the FQHC has to get the specialists to enroll on a direct message service so that they can use SHARE to transfer all orders. Though the FQHC already has the technology to meet the MU requirements, the issue is on the specialists’ side. Hence the EMR SHARE is not helping them meet the MU requirements.

HealthViewX is the Next-Generation Patient Referral Management Solution

1. End-to-End referral lifecycle management with bidirectional EMR/EHR Integration HealthViewX platform supports dynamic forms, workflows, task lists, reports, data visualization and has great integration capabilities. It has enabled our FQHC client to automatically pull referral orders from their EMR in real-time. It has also helped them in configuring all other referral coordinator workflows and tasks with maximum automation. Thus our platform has helped them achieve an efficient end-to-end referral management system.

2. Payer-specific prior authorization process automation

 HealthViewX platform has a payer management module that maintains and manages

  • different payer details
  • their modes of prior authorization
  • direct authorization procedures
  • payer forms
  • online portal links

With this information already present, it provides the referral coordinator the capability to automate

  • prior authorization submission
  • status checks coupled
  • fax integration

3. Automated Specialist / Patient Notification & Reminders with Customizable templates and configurable channels of communication

HealthViewX – Template engine platform along with the communication engine gives the flexibility to the referral coordinators to

  • choose the relevant format and mode of delivery for Specialist / Patient communication
  • tie it along with the referral workflows by setting trigger rules and reminder rules.

4. Secure Online referral portal for Specialists with easy touch points via Fax /SMS/Email

HealthViewX clearly understands the specialists’ referral preferences by,

  • Multi-channel referral consolidation that brings all the referrals from every possible source into a single queue.
  • Detailed referral information through which that the Specialist receives all the necessary referral details.
  • Ability to communicate back and forth (electronically or via fax) in a simple and secure way.

These are few notable features of HealthViewX that have enabled referral loop closure from the specialist side.

5. Free secure Specialist online accounts with both sides integration capabilities to meet Meaning Use requirements

As mentioned earlier, the problem with MU requirements was not, it was not met by the specialists. HealthViewX solution provides free online accounts for such specialists. It was highly useful to our FQHC client as we supported seamless integration between both ends. It helped the specialists meet the MU requirements.

HealthViewX Patient Referral Management application is the next-generation software for patient referral management. It has provided the best solution to the challenges faced by FQHCs. To know more about HealthViewX solution, schedule a demo with us. Our patient referral management experts will guide you through our HIPAA compliant solution.

Five ways In Which HealthViewX Referral Management Can Fix The Referral Problems Of Enterprise Hospitals?

Existing Patient Referral Management Workflow in Large Enterprise Hospitals

In order to understand how a patient referral works in a large enterprise hospital, let us consider a scenario,

XYZ hospital is a large enterprise hospital with 10,000 plus PCPs and specialists. It is a busy hospital that sends and receives 1000 plus referrals in a day.

  1. Mark visits the hospital – Mark hurt his leg and was bleeding. Even after three days, the wound did not heal. He visited his PCP, Dr. James. After examining Mark, Dr.James wants him to consult a diabetologist.
  2. Dr.James does the insurance pre-authorization – The PCP does the insurance authorization manually. He places a request with the insurance company and waits for their response. The process takes time and forces Mark to wait. After about four hours, Dr.James gets the consent of the insurance company for the diagnosis.
  3. Dr.James has difficulty finding the right specialist – St.Luke’s hospital had recently acquired a specialty clinic. Dr.James is not aware of the specialists recently added to the network. So he misses the famous diabetologist within the network and looks for someone outside the network. After considering many factors like the patient’s comfort, specialist’s availability, distance from the patient’s residence, specialist’s experience etc, he finally chooses a receiving provider.
  4. Dr.James sends the referral – Dr.James finally sends the referral to Dr.Hales after trying to reach the specialist office via phone. The line seems to be engaged. He looks for many other ways which will be easy to send referrals but to his disappointment, Dr.Hales accepts only referrals through phone or website.
  5. Dr.Hales schedules appointments – After receiving the referral, Dr.Hales schedules an appointment with the patient. Mark was not notified clearly about the appointment. So he fails to show up. It results in revenue loss for the specialist and patient dissatisfaction with the PCP. Mark who is still suffering from pain and waiting for the specialist to examine him. After two missed appointments, Mark finally visits the specialist.
  6. Referral progress updates and loop closure – Throughout the referral process, Dr.James is in the dark. Dr.Hales is busy and fails to give referral updates to Dr.James. He is anxious to know if Mark was taken care of. Without referral updates, Dr.James cannot close the referral loop.

Challenges faced by Enterprise Hospitals

  1. Insurance pre-authorization – The process of waiting for the insurance company to respond and approve the procedures or medication is time-consuming. If this process is automated it would save time and efforts of providers, insurance companies, and patients.
  2. Finding the right receiving provider – As many of the enterprise hospitals are joint ventures or acquisitions, the PCPs are not completely aware of the specialists within their network. Many times, the PCPs refer their patients to specialists out of their network. Finding the right provider outside the network is the greatest challenge as the PCP has to consider many factors. It is time-consuming and prone to errors when done manually.
  3. Patient Referral Leakage – When a PCP refers the patient out-of-network, it leads to referral leakage. PCP can avoid Patient referral leakage if the patient is referred within the network. When that is difficult, patient referral leakage is inevitable. If the patient is referred out-of-network and is not happy with the care given, the chances of the patient coming back to the PCP is less. Referral leakage causes revenue loss and patient dissatisfaction.
  4. 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.
  5. Referral updates and referral loop closure – When PCP refers patients out-of-network, the chances of getting referral updates are minimal. The specialist is usually busy and does not update the referring provider about the referral. Referral updates are crucial in closing referral loops.

HealthViewX Patient Referral Management Workflow in Large Enterprise Hospitals

Let us consider the same scenario used earlier and see the benefit of HealthViewX referral software to the existing workflow in Large Enterprise Hospitals,

  1. Mark visits the hospital – Mark hurt his leg and was bleeding. Even after three days, the wound did not heal. He visited his PCP, Dr. James. After examining Mark, Dr.James wants him to consult a diabetologist.
  2. Dr.James does the insurance pre-authorization – The PCP does the insurance authorization in the HealthViewX application. HealthViewX places a request with the insurance company and coordinates with them thereafter. The process takes place quickly and gets over in about 15 minutes Dr.James gets the consent of the insurance company for the diagnosis.
  3. Dr.James finds the right specialist in no time – St.Luke’s hospital had recently acquired a specialty clinic. Dr.James is not aware of the specialists recently added to the network. He need not worry as the HealthViewX application is updated with the current list of providers. With the help of the Intelligent Smart Search feature, Sr.James found the right specialist in his network.
  4. Dr.James sends the referral – Dr.James sends the referral to Dr.Hales via HealthViewX application. It supports many channels of referrals like email, website forms, type-enabled pdf, fax, online forms, etc. With the HealthViewX solution, sending out referrals takes not more than five minutes.
  5. Dr.Hales schedules appointments – After receiving the referral, Dr.Hales schedules an appointment with the patient. Mark is notified clearly about the appointment. He meets the specialist on time and gets treated. This improves his satisfaction and Mark plans to visit the hospital in case of any illness.
  6. Referral progress updates and loop closure – HealthViewX application supports a Timeline View that is available to both the referring and receiving providers. It says all about the referral and its history. Dr.Hales is not required to update Dr.James as it is taken care of by the application. Without referral updates, Dr.James can close the referral loop without any delay. Dr.James can receive feedback about the referral from the patient and the specialist. Depending on their remarks, he can improve the process in future.

HealthViewX Patient Referral Management solution is the best choice for Large Enterprise Hospitals. Are you a Large Enterprise hospital looking for a referral management solution to solve your referral challenges? Schedule a demo with us. Our solution experts will be happy to guide you through our HealthViewX HIPAA compliant Patient Referral Management solution.