Tag Archives: medical referrals

5 Healthcare Industry Trends To Watch Out For

With every passing day, the healthcare industry is growing and becoming better. In order to keep up with the huge demand for medicine and treatments, researchers are inventing new systems and technologies. So what are the healthcare trends to watch out for in 2019 and beyond?

The number of baby boomers who retire and come under Medicare or Medicaid is increasing every year. At the same time, medical experts are making unbelievable achievements in treatments and medicine. So it is difficult to predict the number of inventions in the future. But one thing we know for sure is that the healthcare industry has a bright future.

Due to the rapid advancement in technology, the healthcare industry has grown quickly to serve a huge number of people across the world. Despite the uncertainty in the future, it is possible to predict by looking at the medical learning centers because that’s where most of the ideas originate.

So, let us go into the top 5 healthcare trends to watch out for!

  • Electronic Medical Records/Electronic Health Records

Electronic Medical Records (EMRs) are the top of the list. But these are not new so how can it be a trend? Most of the health institutions across the U.S. have adopted the use of electronic medical records and it has positive effects.

According to Assignment Masters, it is necessary to have patients’ records in digital form to not only access these easily but also convenient for medical experts to communicate and share information with other experts in a different area. With these records, any physician can access the patient’s medical history in seconds and this allows him or her to make informed decisions when treating the patient.

Although EMRs have been around for a while, it took some time for health systems across the U.S. to embrace and implement it. Today, most of the health systems use electronic medical records. 

In 2019, we can see how technology will continue improving patient care in the long-term. With digital records, the medical expert can devise effective treatment plans anytime.

  • Smartphones allowed in medical classes

The second trend is all about how technology will not only change systems in hospitals but also in the class. Today, technology has changed how medical experts interact, gather information and make decisions. It has also changed the way medical students are trained. Today, healthcare workers don’t get in trouble for having smartphones and Edugeeksclub in class. In fact, they are encouraged to use these devices to improve their learning methods.

Teachers have also changed their teaching methods. They have reported having an easier time teaching using new equipment and software. It allows them to share important information easily and fast as compared to the traditional lecture which was difficult for the teacher and boring for the student. Students can also collaborate easily through these systems and this gets them prepared for real-life experiences.

  • Artificial Intelligence

It is impossible to discuss the future of the healthcare industry without thinking about artificial intelligence. Artificial intelligence will change and improve healthcare in many different ways. In general, artificial intelligence will open the avenue for human beings and technology to connect. Through this connection, it is easy to monitor and analyze the activity of human beings all over the world easily.

With artificial intelligence, healthcare providers will have the best tools in their hands to treat patients. For instance, using this technology, healthcare providers can easily offer their services in places where there is a shortage of doctors without being there physically. Some experts are predicting that treatments such as radiology will be enhanced to a point that healthcare providers will not need to take tissue samples from patients.

According to Essay Shark, artificial intelligence in the health care industry will increase by $1.7 billion and this is expected to improve performance and productivity by ten to fifteen percent in the next few years. Artificial intelligence will improve efficiency, save time and money and improve the experience of the patient.

  • Medical devices

Technology has made it possible for patients to consult their doctors without having to visit them. Today, doctors and patients can video chat any time they want. After communicating with the patient and analyzing his or her records, the healthcare provider can easily make informed decisions. This is good news for patients who are very old or for people who cannot get out of their houses.

With improvements in technology, our healthcare system will also improve. Medical experts have spent a lot of time and energy innovating medical devices that will revolutionize the healthcare industry. With these devices, you don’t have to wait for days or hours to get your results. They are fast and efficient.

These machines are not only convenient for patients but also to health providers. Their quality of service determines health or sickness and frustration. 

  • Improved quality of service

All technological advancements are centered on improving the experience of the patient. In every profession, the experts are paid based on the quality and quantity of service they render. Technology allows healthcare providers to measure their outcomes based on the hours they log in and the health outcomes of their patients.

It also makes it easier for healthcare providers to determine which type of treatment works best and how to get the best outcome out of them. Tests can be performed quickly and accurately. Medicine and other forms of treatment are available. In the coming years, patients will receive the best care that man has been dreaming and working towards to for thousands of years.

The health care trends discussed above are just but a fraction of what we should expect in the near future. With technology advancing at a rapid rate, we look forward to quick and efficient medical tools and treatments. As technology advances, it will reduce the burden on healthcare practitioners and they will be able to deliver the best quality of service.

Talk to our experts to know more about Healthcare updates.

How To Identify An Under-performing Referral System And Make Improvements For The Same?

For many health systems, referral leakage may equate to millions of dollars in foregone revenue. Every patient who seeks care elsewhere is a lost revenue opportunity now and potentially into the future. Thus it is important for health systems to increasingly focus on minimizing referral leakage while managing referrals. The following are the symptoms of an underperforming referral system which have a negative impact on referral leakage,

  • Disability to identify in-network or aligned providers.
  • Inept or unclear information on what patient types or conditions a provider treats.
  • Limited or no ability to measure the referral management team performance or financial outcomes.
  • Ineffective prioritization and workload management.
  • Increased authorization-related denials and write-offs.
  • Too much reliance on paper-based or manual communication and tracking systems.
  • Increased patient referral leakage due to complicated, cumbersome, or unclear referral processes.

Analyzing your organizations’ opportunity for improvement

The ability to make significant improvements in referral processing efficiency and patient retention depends on the following factors,

  • Degree of process standardization
  • Organization’s accountability
  • Underlying infrastructure
  • Organization of staff
  • Technological capabilities

Accountability and standardization of the process

There is a huge communication gap between the referring provider and receiving provider offices which makes the process inconsistent. Organizations often fail to standardize the process by defining who is responsible for

  • Obtaining prior authorizations
  • Locating a specialist with good access who will treat the patient’s condition
  • Gathering relevant medical records
  • Contacting the patient to schedule the appointment

Organizations with strong referral management programs have developed a consistent and standardized workflow that clearly delineates responsibilities by role. Achieving this level of efficiency requires that operational and clinical leadership collaborate to design and develop policies, procedures, standards, and workflows to support strong referral management practices.

Technology Systems and Capabilities

Despite having a thoughtful and disciplined approach to monitoring and managing referrals, technology systems are often unable to facilitate best practice workflows or deliver the performance data necessary to effectively manage the end-to-end process. Therefore, the following processes have been happening manually,

  • Tracking authorization status
  • Monitoring scheduled appointments
  • Calculating referral conversion rates, staff productivity, and downstream revenue

Furthermore, the inability to share information electronically among providers necessitates increased use of paper-based and faxing processes. Without the proper supporting technologies, there is increased processing effort and workload, risk of lost or inaccurate data, and, most importantly, the potential to delay patient care.

The following are the technological capabilities needed to support the best practice referral, management team,

  • Identifies providers in the referral system
  • Matches patients with the ideal scheduling providers
  • Prompts follow-up when appointments are not scheduled or care is not received
  • Facilitates the transfer of post-visit documentation between providers
  • Supports detailed reporting to manage performance

Close your referral loops with the HealthViewX Patient Referral System

Information Technology enables patient referral workflow automation. HealthViewX Patient Referral Management System simplifies the process and closes the referral loop on time.

  1. The Primary Care Provider (PCP) identifies the need for a referral and initiates the same through the EHR system.
  2. The referral coordination team then validates the referral and does the insurance pre-authorization with the help of HealthViewX solution.
  3. The Intelligent Provider Smart Search feature of HealthViewX Patient Referral Management System helps in finding the right specialist or imaging center easily.
  4. The referral coordination team then sends the referral with the necessary documents to the relevant specialist or imaging center through the HealthViewX platform.
  5. The receiving provider gets notified about the referral and can schedule appointments with the patient.
  6. The patient and the receiving provider get reminders of the appointments thus reducing no-show rates.
  7. The referring provider is also notified about the status of the referral and how it is progressing. HealthViewX timeline view makes tracking and managing the referral lifecycle easier.
  8. HealthViewX tracks and sends reminders to the receiving provider to update the diagnosis, treatment recommendations, care plans in the referral.
  9. HealthViewX makes it easy for the referring provider by automatically updating this information back to the EHR system.
  10. Thus the HealthViewX solution closes the referral loop on time and helps in easy monitoring of the same.

Features and Functionalities

  • Referral workflow automation reduces the time and manual effort spent on a referral. Thus HealthViewX solution improves the efficiency of the process.
  • Patient coordination framework achieved through the patient application that helps in managing appointments and log data for the care plans prescribed by the provider.
  • Automated insurance pre-authorization reduces the work of the referral coordination team and makes the process simple.
  • The Intelligent Provider Search feature helps in finding the right specialist or imaging center in no time.
  • Referral timeline view and communication enables an easy flow of information between the referring and the receiving ends.
  • Scheduler integration gives timely reminders and notifications to the patients and providers about appointments, lab tests, etc.
  • Referral insights and analytics gives the PCPs concrete data of how many referrals were converted to an appointment by a specialty care or an imaging center. It will help in analyzing who responds quickly and to whom the PCP can direct future referrals.

Benefits of closing the patient referral loop in the healthcare industry

  1. Increased Medicare reimbursements –  Medicare considers closing medical referral loop as a benchmark for giving reimbursements. Closed medical referral loops increase the opportunities for Medicare reimbursements for referral marketing.
  2. Streamline referral management – With HealthViewX Patient Referral System in place, the referral workflow is automated and streamlined.
  3. Improved patient care – Reduced waiting time gives patient satisfaction thereby improving the care quality.
  4. Increased productivity – Reduced operational time improves the efficiency of the patient referral system.

HealthViewX Patient Referral Management application helps in closing the referral loop and increases the revenue for the practice. To know more about HealthViewX solution, schedule a demo with us. Our patient referral management experts will guide you through our HIPAA-compliant solution.

Why Should Federally Qualified Health Centers Give Virtual Communication Services To Their Patients?

Virtual communication services in FQHCs

With effect from January 1, 2019, CMS has released a new reimbursement plan for FQHCs. It says,

“FQHCs can now receive payment for virtual communication services when at least 5 minutes of communication technology-based or remote evaluation services are furnished by an FQHC practitioner to a patient.”

The patient must have had an FQHC billable visit within the previous year, and both of the following requirements are met:

  • The medical discussion or remote evaluation is for a condition not related to an FQHC service provided within the previous 7 days.
  • The medical discussion or remote evaluation does not lead to an FQHC visit within the next 24 hours or at the soonest available appointment.

Virtual Communication in the age of COVID-19

On March 27, 2020, the Federal Government signed the Coronavirus Aid, Relief, and Economic Security Act (CARES Act). The CARES Act was developed to support the American economy during the COVID-19 Pandemic. Section 3704 of this Act allows FQHCs to utilize telehealth services to access eligible Medicare beneficiaries. The price for such long-distance telehealth services is $92. 

How can FQHCs receive payment for virtual communication services?

To receive payment for Virtual Communication services, FQHCs must submit an FQHC claim with HCPCS code G0071 (Virtual Communication Services) either alone or with other payable services. Payment for G0071 is set at the average of the national non-facility PFS payment rates for HCPCS code G2012 (communication technology-based services) and HCPCS code G2010 (remote evaluation services) and is updated annually based on the PFS national non-facility payment rate for these codes.

What is the payment rate for G0071 and G2012?

HCPCS code G0071 is set at the average of the national non-facility PFS payment rates for HCPCS code G2012 (communication technology-based services). HCPCS code G2010 (remote evaluation services) and is updated annually based on the PFS national non-facility payment rate for these codes. For 2020, the payment amount for code G0071 will be $13.53 (average of HCPCS codes G2012 and G2010).

What types of practitioners in FQHCs can furnish virtual communication services?

Technology-based communication and remote evaluation services are billable by FQHCs only when the discussion requires the skill level of an FQHC practitioner. FQHC practitioners are physicians, nurse practitioners, physician assistants, certified nurse midwives, clinical psychologists, and clinical social workers. If the discussion could be conducted by a nurse, health educator, or other clinical personnel, it would not be billable as a virtual communication service.

What types of communication technology can be used?

Virtual communication services should be initiated by the patient contacting the FQHC by

  • Telephone call
  • Integrated audio/video system or
  • Store-and-forward method

The Store and forward method includes sending a picture or video to the FQHC practitioner for evaluation and follow up within 24 hours. The FQHC practitioner may respond to the patient’s concern by telephone, audio/video, secure text messaging, email, or use of a patient portal.

How can HealthViewX help FQHCs in giving virtual communication services to their patients?

HealthViewX has the following features that will enable FQHCs in providing communication services to their patients,

  1. Inbuilt audio and video calling apps – HealthViewX supports audio and video calling options that help practitioners in contacting their patients easily.
  2. Secure messaging – HealthViewX has an asynchronous messaging option that enables providers to chat with patients and discuss their health plans.
  3. HIPAA compliant data security – The solution is HIPAA compliant and offers secure data exchange. It supports almost all formats of files and keeps the patient documents safe.

With HealthViewX Patient Referral Management solution in hand FQHCs can stay in touch with their patients easily. A 30-minute demo with our team will help you know how effectively our solution can give virtual communication services to your patients. To know more schedule a demo with us.

Relevance and use of patient referral management software to FQHCs and large enterprise hospitals

Money inflow is very important for medical practices. Without a constant source of revenue, medical practices cannot pay bills, pay employees or take care of patients. Importance of revenue is no different for Federally Qualified Health Centers, Community Clinics, Large Enterprise, and Specialty Hospitals. One way to ensure constant revenue is by retaining patients within the hospital network and providing optimal patient care. To do this efficiently, hospitals use patient referral management software.

Role of FQHCs:

FQHCs play an important role in supporting their community and providing care services to the underserved. Due to this, they may experience financial issues at uncertain times. When budgetary resources are strained, it is critical for an FQHC to

  • Operate with maximum operational efficiency
  • Preserve financial security
  • Maintain staffing levels to continue operations

Inefficient and improper business processes will lead to patient dissatisfaction which will result in patients leaving the practice. FQHCs must concentrate on

  • Maximizing their business and staff efficiency
  • Minimizing financial risks

The relevance of patient referral management software to FQHCs

It is important for FQHCs to take good care of their patients. Factors such as waiting time, improper schedules, referring to the wrong provider, etc create patient dissatisfaction. Using referral management software, providers can access patient health records, schedule appointments and choose providers based on diagnosis and preferences. FQHCs can reduce patient-show rates, decrease referral leakage and also improve patient satisfaction.

FQHCs traditionally prefer working with EMR/EHR systems because they are comfortable with it. An EHR/EMR system has many advantages but when it is complemented with a Referral Management software practices can experience many more benefits.

The relevance of patient referral management software to Enterprise Hospitals

The following challenges in the patient referral workflow are common in enterprise hospitals across the USA.

  • Limited provider information – Physicians do not have information about the providers within their network. This is to blame for unnecessary out of network referrals. Providers who refer out of network could avoid at least one-third of these if they had access to more robust information about providers in their networks. Even when physicians have access to their health system’s provider directories, they are not using the directories because they don’t have the level of information that is needed.
  • Inadequate referral information – Even when physicians refer their patients out-of-network, the chances of a successful referral are less. This is because many providers who receive referrals rate referral information as poor. Without referral information, receiving providers cannot treat their patients effectively.
  • Inefficient patient appointment scheduling – For providers who schedule an appointment for the patient, they prefer doing it through the phone to shared electronic health records system. When heavy use of the phone occurs, it is difficult for providers to see capacity in their network to book the next available appointment. So they bypass the network and book the appointment before the patient leaves the office.

For FQHCs and Enterprise Hospitals, additional investment in a patient referral solution is recommended for the following reasons:

  1. Outbound and Inbound 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 the 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. With this, the providers can always be aware of how the referral is progressing.
  3. Workflow and Task Management – A workflow can be defined by how the referral flow must be(business rules). Tasks can be created 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 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 Patient Referral Management solution smooths the referral process and solves most of the inbound and outbound referral challenges for Large Enterprise Hospitals. Do you want to know more about HealthViewX HIPAA compliant Patient Referral Management solution? Schedule a demo with us.

Patient Referral Management Simplified using Referral Management Software

Following features of HealthViewX simplify patient referral workflow for FQHCs and Enterprise Hospitals:

  1. Outbound and Inbound 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 the 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. With this, the providers can always be aware of how the referral is progressing.
  3. Workflow and Task Management – A workflow can be defined by how the referral flow must be(business rules). Tasks can be created 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 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 Patient Referral Management solution smoothens the referral process and solves most of the inbound and outbound referral challenges for Large Enterprise Hospitals. Do you want to know more about HealthViewX HIPAA compliant Patient Referral Management solution? Schedule a demo with us.

Pros and Cons of Patient Referral Management Software: All you need to know

Advantages of HealthViewX patient referral management software

  1. Inbound and Outbound Patient 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 the case of outbound referrals, it facilitates integration with the existing system to read the patient data and send out referrals.
  2. Referral Timeline – 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. With this, the providers can always be aware of how the referral is progressing.
  3. Workflow and Task Management – A workflow can be defined on how the referral flow must be(business rules – who sends it, to whom, what data must be included). Tasks can be created 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 – HealthViewX is HIPAA compliant and enables secure data exchange of all patient-related documents.
  6. Seamless Integration – Minimal disruption in the existing referral flow by integrating with any EMR/EHR/RIS or Third Party application.
  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 a complete view of incoming and outgoing referral pipeline, referral volume, referral status, patient follow-ups, etc.
  10. Insurance Pre-authorization – HealthViewX supports automated insurance pre-authorization that reduces the manual work of the referral coordinators and saves 10 minutes of manual work per patient.
  11. Intelligent Provider Match – The solution supports an “Intelligent Provider Match” Feature that helps in finding the right specialist/imaging center easily based on the diagnosis, relevance, location, distance, patient preference.
  12. Seamless communication – HealthViewX solution has an inbuilt audio calling and messaging application which is secure and enables faster communication
  13. HIPAA compliant data security – HealthViewX is HIPAA compliant and offers secure data exchange. It supports almost all formats of files and keeps the patient documents safe.
  14. Referral loop closure – Referral updates are hard to miss making it easier for timely referral loop closure.

Disadvantages of patient referral management software and the hindrance to its usage

  1. Capital investment: Depending on the number of referrals processed and the size of the referral network, healthcare organizations are billed quarterly or annually. This is an additional recurring expense.
  2. Misunderstanding that ‘EMRs are enough’. With EMR implementation being widespread across the USA, its acceptability is increasing. Most health care organizations that have gone through the process of evaluating, comparing different EMR/EHR management systems, choosing, implementing and training their staff on its usage are wary of repeating the process. They definitely see benefits from using EHR systems and feel the satisfaction of process improvement more than the urge to improve further.
  3. Mindset – Psychologically organizations are more open to EMR EHR implementation than patient referral software and often compare the two rather than evaluate wholesome benefits.

HealthViewX Patient Referral Management solution smoothens the referral process and solves most of the inbound and outbound referral challenges for Large Enterprise Hospitals. Do you want to know more about HealthViewX HIPAA compliant Patient Referral Management solution? Schedule a demo with us.