Tag Archives: medical referrals

Increasing Patient Retention and Revenue with Referral Management

The ratio between the number of dentists and the population in the USA is 61:100000. More than one in five (21.3%) said that they had not visited the dentist in the last few years. One of the top reasons adults cite for avoiding the dentist is the inability to find a convenient location or appointment time. Specifically, 19% of adults had not visited the dentist in a few years because they cannot find a convenient location or appointment time. As a dentist or dental practice manager, it is crucial to not just manage existing patients but to account for lost opportunity and plan to improve patient experience, especially with appointment schedule and completion. This will result in an increase in the number of patients visiting dental centers. 

Dental centers/groups can begin by leveraging technology to manage the patient referral workflow. Inbound patient referrals having dental issues usually have accompanying ailments such as diabetes or accidental injuries. A seamless experience from appointment scheduling to treatment completion will positively impact patient satisfaction and the volume of inbound patient referrals.

Existing Patient Referral Management Workflow in a Dental Center

Did you know? In a year, 15 billion faxes are sent out with patient referral information 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 or dental group is a high inbound referral setup. Dental centers receive large volumes of referrals weekly (ranging from 50 per week to even several hundred per week) depending on the number of patients visiting the center and the 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.

How to increase Revenue with Referral Management

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 a referral coordinator in a completely manual process can be reduced by using technology. Productivity and efficiency are 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 a 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

  1. Revenue loss is a direct result of the untimely processing of referrals
  2. Providers stop referring to the center thereby harming its reputation
  3. Waiting times and appointment scheduling process affects patients requiring critical and          immediate attention

Challenges Faced by a Dental Center

  1. Multiple Referral Channels: For the specialist/imaging center that receives referrals, face more difficulties than the referring provider. They 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.
  2. Appointment Scheduling and 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.

Let us review a typical referral process to elaborate on the challenges faced by the dental centers.

  1. 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.

  1. 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 on his condition and problems to him. This is time-consuming for the specialist as he wastes time on the same information twice.

  1. 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.

  1. 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 understand the analytics of his specialty.

Overcome your challenges with HealthViewX Patient Referral Management Solution:

With a Referral Management solution like HealthViewX, you can eliminate all your challenges and achieve referral loop closures in an efficient way. Here are some of the key features that will help you transform your referral process:

  1. 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.

  1. 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.

  1. Referral Tracking

HealthViewX gives a clear picture of how a referral has progressed with the help of a timeline view. Every referral has a status that 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.

  1. 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 applications are a secure source for sending and receiving referrals. Also, documents can be attached and sent as a referral.

  1. 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.

  1. Secure Data Management

HealthViewX Patient Referral Management is HIPAA compliant. It manages all patient-related documents securely.

  1. 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.

Talk to us to understand how to streamline and automate the end-to-end referral cycle without disturbing your existing EMR setup.

It’s time to stop faxing referrals – Why are we still faxing patient referrals?

One out of every three patients is referred to a specialist each year. These referrals are sent to specialists, imaging centers, etc., through multiple channels like phone calls, fax, emails, website forms, etc., and fax is the most commonly used channel. Despite the array of digital patient referral management software available in the market, health systems are still following the old school model of referring patients through fax machines and paper-based letters.  Ironically, there could be multiple barriers like the reasons listed below for not using the electronic referral communication software

  • Traditional workplace culture
  • Not having the right technology in place
  • Not understanding the software usage
  • Peers not using eReferrals 

Healthcare professionals need to understand the usability, security, and interoperability of the solutions available in the health IT market. Health systems need to adapt to more secure means to send and receive referrals. With that being said, Referral Management Solution is progressively vital for better patient experience and care coordination. Today, in most health systems referral workflows are poorly documented, insecurely sent and are not effective in providing quality care for patients.

Knowing the security consequences of maintaining paper-based systems and physical paper letters is critical – as they could be easily misplaced and accessed by unauthorized people. Some health systems still depend on their EMR to manage their referral process but they need to understand that EMR’s are not equipped enough to handle the end-to-end referral process. Health systems should understand the need of having a good patient referral solution.

Why do health systems need a good patient referral solution?

The healthcare industry is constantly scrutinized for inefficiencies in processes, systems, operations, etc. As a result, health systems are under more pressure to do more with fewer amenities. Inefficient referral processes lead to long lead times and are inconvenient to both patients and providers. A referral solution can streamline communication between the referring provider, receiving provider, patient and other healthcare providers, save time, enhance care quality and a lot more for both patients and providers.

Other Key Benefits of referral solution include

  • Reduced wait times for patients
  • Better referral tracking
  • Improved referral quality
  • Cost reduction
  • Enhanced operational efficiency
  • Secure transfer of patient information
  • Reduced referral leakage

Referral management solution is important for better patient experience, care coordination and to arrest patient leakage. Health systems lose millions of dollars due to referral leakage as every patient seeking care outside the network is lost revenue. Minimizing leakage is an increasingly key focus for many health systems. Health systems need to make substantial improvements in processing referrals efficiently, improve processes and invest in technologies. It is high time for health systems to stop receiving and sending unsafe fax referral and have a streamlined end-to-end referral solution in place.

A streamlined referral management solution has the potential to standardize the referral process, maximize efficiency in the referral process, and improve workflow through technology. Talk to our experts today and schedule a demo to understand more about our Patient Referral Management Solution.

Transform Your Care Practice With A Streamlined Patient Referral Process

It is imperative to transform your care practice to deliver value-based care. Promoting and exploring technologies for streamlining various processes is the way forward for improved care quality and care coordination. One such process that requires a transformation in care practices is the patient referral process which is still a tedious, fragmented, and time-consuming task for referral coordinators in many health systems. The conventional patient referral process (both inbound and outbound) results in more stress for the referral coordinators and poor patient satisfaction. This inefficiency in the patient referral process leads to frustrated referral coordinators, physicians, specialists, patients and health systems as a whole. Patients not showing up for scheduled appointments are revenue loss for health systems that are trying to keep their patients within the network for better outcomes.

Today’s patient referral process makes it hard for patients to get the care they need, and healthcare facilities the visibility they need in the process. Additional challenges like lack of communication amongst providers, appointment delays, no-show rates, incorrect referral, etc. all have far-reaching consequences. Ineffective communication between clinical teams leads to poor health outcomes of patients and lost revenue for health systems. It is not a surprising fact, that more than half of the PCPs and Specialists are dissatisfied with the information they receive during a referral.

How to eliminate these challenges in the referral process?

A technological referral solution that offers end-to-end automation and is convenient for patients and providers is required to actively manage referrals and improve efficiency.

Healthcare providers need to adapt to an advanced technological solution that

–          is patient experience focused, process-driven, and easy to use

–          improves PCP, specialist experiences

–          has end-to-end referral workflow automation

–         intuitive dashboards with data insights and analytics

HealthViewX Patient Referral Management Solution is designed to help providers to focus on delivering high-quality coordinated care by keeping track of their patients throughout the care continuum. The solution makes the referral process efficient and simple with no burden on practice staff. It helps improve patient experience, reduces the burden on staff, improves operational efficiency, and overall benefits the health system in processing referrals.

Streamlining the patient referral process can help with

–          better care for individuals and the community as a whole

–          lowered cost and improved operational efficiency

–          reduced paperwork for referrals

–          awareness of in-network and out-of-network providers

–          improved patient experience and value-based care drive

–          better care coordination among providers

–          visibility into real-time data to understand referral patterns, referral staff performance, patient status tracking, and gaps in care.

HealthViewX Patient Referral Management Solution helps solve challenges in all stages of the referral workflow to meet the needs of the patients, healthcare providers, and payers, and also integrates seamlessly with all EMR systems. An intelligent end-to-end automated solution is essential for better provider connectivity, reducing network leakages, improving quality care, and better health outcomes.

Schedule a demo today with our experts to understand how our solution seamlessly solves challenges in the patient referral process.

The Role of Referral Management in Value-Based Health Care

What is Value-Based Care?

Value-Based Care is a care delivery model in which healthcare providers are paid based on the health outcomes of the patient. Value-based is a quality-based care model that drives “better health for all” and benefits the community, providers, and payers as a whole. Value-based care helps healthcare providers by helping patients improve their health and reduce the prevalence of chronic illness. This care model is a potential swap for fee-for-service reimbursement based on quality. The providers are paid based on the health outcomes of the patients and are rewarded for helping patients’ improve their health. The ultimate goal of value-based care is to optimize the care for the patient population.

What are the benefits of Value-Based Care?

For Patients – Reduced cost and better health outcomes

For Providers – Better patient satisfaction and improved care efficiencies

For Payers – Stronger control on costs and lowered risk

For Community – Reduced spend on healthcare and improved overall wellbeing

What is a Patient Referral Management Solution?

Patient Referral Management Solution is a patient referral tracking tool for end-to-end referral communication and management. The solution is designed for healthcare organizations to enable them to provide better care with a well-orchestrated customizable workflow. Its primary goal is to enhance and streamline interaction among all care providers involved in patient care for better patient outcomes.  

Role of Patient Referral Management Solution in Value-Based Care

Right from small to large, healthcare providers face a lot of challenges in their referral process. Poor communication and referral workflow among providers lead to diminished care quality and patient experience. Lack of timeliness of the information and inadequate patient information or reports all contribute to poor care continuity, patient dissatisfaction, and poor health outcomes.

A well-orchestrated and automated patient referral solution has the potential to transform referral workflows and help providers improve their patient health outcomes. It helps provide value-based care through better care coordination throughout the care journey. A referral management solution can help improve efficiency, reduce time spent on redundant tasks, cut down on overhead costs, reduce referral processing time thus helps both providers and patients. Streamlined workflows lead to better patient outcomes.  The prime objective of the solution is to improve patient-physician interaction and provide value-based care for better patient outcomes.

Why is Referral Management crucial for Healthcare Providers? 

Referral Management is very crucial for healthcare providers to track and manage referrals, and ensure better patient outcomes. Referral management is essential when

  • referring and receiving providers have different EMRs/EHRs
  • healthcare providers are coordinating between in-network and out-of-network providers
  • health systems are looking to improve patient health outcomes and reduce no-show rates
  • providers want to increase revenue and reduce operational cost
  • health systems want to focus on quality care by using value-based care models 

A major challenge in the current referral process is that most EMRs are not equipped enough to handle the end-to-end referral process. A referral management solution helps healthcare providers to track and manage their end-to-end referral process with complete transparency. The solution helps streamline workflow, reduce clinical errors/delays, cut down the processing time by automating multiple touchpoints, and obtain strategic data/facts for informed decision-making. The prime objective of the solution is to enhance communication among healthcare providers involved in patient care.

By leveraging technology the healthcare industry can provide value-based care for their patients and better patient experience. An end-to-end patient referral tracking ensures timely care, improves care coordination and better outcomes. HealthViewX referral management solution is designed to suit any practice, customized to meet user requirements, and enables data-driven decision support, and provides real-time insights of patient-reported data to promote better care delivery. Schedule a demo today to understand more about our HIPAA Compliant SaaS-based referral solution from our experts. 

How to reduce referral leakage in large hospitals?

For many large enterprise hospitals, referral leakage may amount to millions of dollars in lost revenue. Patient referrals are an important revenue generator for hospitals and losing patients to other providers can cost these hospitals upto 20 percent of their revenue. Dissatisfaction with the current referral process is widespread and every patient seeking care elsewhere is now, and potentially in the future a lost revenue opportunity for the hospitals.

Signs of an underperforming referral management system that results in referral leakage:

Inability to get complete information to process referrals at one go:

Communicating complete patient information at the time of specialty referral is crucial for high-quality consultation and coordinated patient care. The inability to get complete information leads to patient dissatisfaction, delay in processing referrals and referral leakage.  

Difficulty in finding the right provider within the network:

One of the major causes of patient referral leakage is difficulty in finding the right specialist within the network. Nearly half of the physicians surveyed said they have trouble determining who is in-network. Physicians could avoid referring out-of-network if they had information about all in-network providers.

More time spent in processing each referral:

On average referral coordinators take 15-20 minutes or sometimes more to process each referral on the receiving end just for checking missing patient information. The staff time spent coordinating referrals and their visits is tedious and time-consuming.

High patient no-show rates and referral leakage:

Patient no-show rates or missed appointments cost the U.S. health systems more than $150 billion a year. Lack of quality care and coordination among care stakeholders leads to higher no-show rates or referral leakage, due to which patient experience takes a big hit.

Manual communication and tracking systems:

Manual processes like insurance preauthorization, checking for missed patient information, etc are time-consuming Such time-consuming and cumbersome manual processes may lead to patient dissatisfaction.

Lack of referral analytics for informed decision making:

Lack of data of the referrals flowing in and out of the network affects decision making. Referral analytics gives comprehensive data on the number of patients with various referral status.

The ability to significantly improve the effectiveness of the referral process lies in the referral process standardization and technological capabilities.

Here’s how to reduce referral leakage

Standardization of processes:

Inconsistency in the patient referral process between the referring provider and the receiving provider is common. Right from obtaining prior authorization, finding the right specialist for the patient, collecting the required information for the referral, coordinating for patient appointments, etc. large hospitals are often challenged throughout the process. Hospitals need to streamline their referral workflow to achieve efficiency and have standard workflows and processes to streamline the end-to-end referral process. Achieving this efficiency in the referral process requires well-defined workflows.

Technology solution and capabilities:

Despite having an approach to monitoring and managing patient referrals, existing systems are often unable to simplify referral workflows to effectively manage the end-to-end referral process. Right from tracking authorization status, scheduling appointments, calculating referral conversion rates, staff productivity, etc. all are challenging in the current referral process. A referral solution that is efficient, technologically advanced, and has the capability to automate the end-to-end referral process is the need today. Connecting the information to objectives, understanding the workflow to obtain the information, and most importantly getting the data analytics for informed decision making will be more valuable.

Referral Management Solution – A worthwhile investment

A focused referral management process has the potential to maximize utilization, standardize processes, and enable streamlined workflows. Hospitals need to invest in solutions that will reduce referral leakage and increase patient volumes.

HealthViewX Patient Referral Management solution has features that best suit a hospitals’ Referral Management System.  A 30-minute demo with our team will help you understand how effective our solution can track and manage the referral life cycle.

How to become a preferred health system for patients and referring physicians?

Healthcare technologies like telehealth, remote patient monitoring, referral management, etc., have simplified the process for health systems to deliver care for their patients. These advancements are uniquely qualified to help health systems attract patients to their facility and build their brand.  

So how do you become the preferred health system? What are the strategies behind becoming a preferred health system for your patients, and also for physicians referring patients to your health system?

Care coordination is the responsibility of any system of care and has the potential to transform healthcare delivery, improve the overall effectiveness, and efficiency of any health system. Thus, the key to becoming the preferred health system for patients is to have well-executed care coordination.

For effective care coordination, it is important to connect your entire physician community with specialists and make sure they work in unison to ensure your patients’ health needs are met and the required care is delivered.   

If care coordination is done in the right manner, it can improve health outcomes and patient experience along with the growth of the healthcare system. This way, patients, providers, and payers can get benefited. Though there are different definitions for care coordination, in the end all of them point to the same goal which is to become patients’ preferred care provider.  

Healthcare technology

Here are a few tips to become patients’ preferred health system

1. Connecting an entire network of physicians and specialists:

It is important to connect your entire set of physicians and specialists to provide quality care for each and every patient. HealthViewX end-to-end patient referral management connects your entire care network and helps you achieve this with ease.

2. Improve care coordination:

The major priority of all healthcare providers is to achieve care coordination and improve patient care but unfortunately, it still remains a challenge in the industry. The right coordinator may differ from patient to patient. Critical patient information should be readily available for all involved inpatient care. Improved care coordination results in better patient outcomes and patient satisfaction.

3. Effective communication channels and methods:

Software solutions that support upsurge communication and engagement among providers are still lacking. Manual processes (phone call, email, fax, etc.) can lead to fatigue and operational inefficiency. An end-to-end automated solution would help eliminate this challenge. One can improve the quality and continuity of care provided to patients by focusing on improving the transfer of patient information.

4. Gaining the trust of out-of-network providers/physicians:

PCPs prefer hospitals that are easy to work with. It is essential to build and maintain a strong referral base from out-of-network providers/physicians. Hospitals need to work to become a referral partner of choice for physicians and so creating a strong referral base with the referring physicians will pave the way to steady patient inflow. Hospitals should work to encourage out-of-network physicians to become more actively involved in patient care. Lack of communication can lead to poor patient health outcomes.

5. Closing the referral loop:

Planned integration of patient care between providers will help attain better service. As health systems grow more complicated, it is essential to close the referral loop for patient record and safety. The goal of referral loop closure is to track and support patients when they obtain services outside the practice. Closing the referral loop is one of the ways to become a preferred provider.

Health systems need to adopt new healthcare technologies that have the potential to improve patient care and satisfaction. One such technology that health services need to implement is patient referral management. The present referral management is complex, and coordinating care is hard for the health systems. Navigating the healthcare system or care set-ups can be tiring for patients too. Poor coordination can result in reduced quality of care, higher readmission rates, increased no-show rates, referral leakage, and higher cost of care. Better care coordination may result in more satisfied patients.

End-to-end referral tracking and follow-up is a must for effective patient care. Patient Referral Management is one such solution that can solve major challenges faced by health systems in their referral process.

Schedule a demo with HealthViewX Referral Management Solution experts today!