Tag Archives: patient referrals

Advantages FQHCs Gain From A Patient Referral Management Solution

Community health centers or federally qualified health centers provide critical primary care services to tens of millions of people every year. Their role in healthcare makes them necessary access points for patients coming into the vaster healthcare system. Let us see how these organizations use patient referral management systems to leverage their role as a crucial source of patient referrals and enhance the care they can provide for their populations.

1. Making a more combined provider network:

Right from small to large, FQHCs are moving towards providing value-based care for their patients. Many FQHCs have discovered that requests for better care coordination with specialists go unheard until there is a change in the current referral process. FQHCs have realized that technology can provide them with the ability to differentiate from their competitors while helping them deliver quality care to their patients and closing referral loops. An efficient referral management solution will help them organize, quantify, and ultimately shape their referral stream and improve care coordination.

2. Improved patient support and access to care:

Insurance prior authorization is one of the major challenges in the patient referral process. Finding the right specialist, insurance prior authorization, ensuring the patient visits the specialist, getting the information back, and updating the information back to the EMR is all crucial inpatient care. A referral management solution helps FQHCs to automate end-to-end referral process and helps them close referral loops with ease. This improves patient experience and increases their access to quality care.

3. Improved referral workflows:

Many FQHCs lack care coordination in their current referral process. Manual processes are both time-consuming and tedious. Simplifying the referral workflow will not only help referral coordinators and patients but will also help the FQHC performance as a whole.

4. Better care coordination and patient outcomes:

In an efficient referral process, patients get the care they need. This involves referring the patient to the right provider, ensuring insurance pre-authorization, scheduling appointments, sending reminders, and updating the patient information back into the EHR. All these steps contribute to better care coordination and patient outcomes.

5. Increased referral loop closures and MU Credits:

Receiving a report from the provider to whom the patient was referred to and updating that information back into the EHR is critical for FQHCs. Referral loop closure is essential for better care coordination and will help FQHCs improve patient experience and outcomes. A referral solution that is MU stage 3 certified can help the practice with MU credits, as referral transferred using the platform can be counted for MU credits.

Talk to our solution experts to know more about Patient Referral Management Solution.

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.

Why do hospitals need a patient referral management solution?

Today, hospitals face numerous challenges in their day-to-day operations. One of the biggest challenges is managing their high-volume inbound and outbound patient referrals. Right from receiving patient referrals through multiple channels like email, fax, phone, etc., this method is often information-intensive and document-driven, requiring greater control and visibility of the entire process.

Patients have difficulty navigating through the referral process, and this experience directly impacts the quality of care. Poor referral management negatively impacts hospitals, and hence clinical staff needs to be careful in processing every referral. An inefficient referral process leads to patient dissatisfaction, patient leakage, loss of revenue, missed appointments/no-show rates, overall operational inefficiencies, etc.

Successful clinical practice depends on effective collaboration and communication among the parties involved in patient care. A solution such as patient referral management for large hospitals has the power to enhance communication beyond the four walls of a healthcare facility. It extends communication to all parties involved in patient care, including the patient. Such solutions can have enormous sway on enhancing the patient experience while driving overall operational efficiency.

Top reasons why hospitals need a patient referral management solution

1. Doesn’t let you miss any referral

Hospitals send and receive high-volume patient referrals through multiple-channels like emails, fax, website form fills, direct messaging, etc. It becomes difficult to track every referral, and there are high chances of missing out on them. An end-to-end patient referral solution will bring all referrals in one single queue and eliminates referral leakage. Referrals from physicians are a key source of revenue for hospitals and they would not want to miss out on them.

2. Engages patients throughout the referral process

Hospitals need to involve patients’ in the referral process. Engaging patients will not only increase process visibility for patients’ but also gives them a clear expectation and visibility into their care transition. Involving patients in the referral process directly impacts the standard of care patients’ receive from the hospital. Overall, engaging patients’ will help reduce referral leakages, improve patient satisfaction, and increase revenue.

3. Referral patterns and metrics/analytics

Referral solutions help hospitals understand their referral patterns and appointment conversion rates. Customized reports and analytics on referrals will help hospitals gain better insight into their business, using analytics such as the metrics dashboard, referral volume, referral patterns leakage rate, wait times, etc. help them with informed decision making.

4. Involves and engages key players for better results

To drive results and for better outcomes, it is crucial to include all the key players’ involved in patient care. Patient referral management solution helps people in different designation achieve their goals at the same time helps provide quality care for their patients. Persona-based reports help each of them in informed decision making.

HealthViewX Patient Referral Management solution helps practices in managing their referral network and increasing their revenue. Are you referral inbound & outbound-heavy practice looking to track all your referrals very effectively? To know about HealthViewX Patient Referral Management System in detail schedule a demo with our team.

Patient Leakage – A major problem to hospitals and health systems

Patient leakage is a rampant problem that healthcare providers are dealing with on a day-to-day basis. Hospitals/health systems rely on patients being referred by out-of-network physicians.

Poorly handled or mismanaged patient referrals are a significant problem for many health systems that can lead to patient leakage and in-turn revenue loss. Patients being referred out of network is one of the main causes of patient leakage. Health systems are said to lose up to 20% of revenue due to patient leakage.

Patient Leakage – How does this happen?

In some cases patient leakage is inevitable. For example, if a person has to be referred to any particular specialty care or treatment that is unavailable within the network then the referring provider has no choice other than referring the patient out-of-network.

Conversely, there are several other reasons where in-house providers refer patients out of their network

1. Provider Reputation

At times the provider may refer the patient out-of-network depending on the specialist availability, reputation, experience, specialist rating, and patient satisfaction. It can also be due to unavailability of that specialist within the network. Providers are responsible for their patients’ health, so they would ensure they give the best possible treatment or reference for their patients. This is the main example of how patient leakage happens.

2. Unawareness:

New providers who have joined the health system may not be aware of all the specialists available within the care network. There are high chances that providers may refer patients out of network if they are unaware of specialists within the network.

3. The patient chooses the specialist he/she wants:

The provider has to accommodate patient needs and ensure the patient is satisfied with the care provided. Patients’ may choose the provider based on their convenience or preferences like distance, personal preference, specialist rating, etc. Finally, the decision of choosing the specialist completely depends on the patient’s decisions. This is one of the reasons why patient leakage happens.

4. Provider-Patient Relationship:

This is also a prime reason for patient leakage. It is important that the providers build a strong relationship with their patients through quality and value-based care models and if this lacks chances are high that patient may leave the care network.

5. Distance:

Distance and location play a major role in patients opting/choosing their providers. If competing facilities are much closer than the location you refer, patients would prefer the location of their convenience.

Do Health systems understand the amount of revenue loss?

Health systems/ large hospitals do not realize the actual amount of missed revenue due to patient leakage and missed patient appointments. Health systems have lost millions of revenue due to patient leakage and they do not properly track patient leakage. Even though health systems leaders track these leakages it is difficult for them to have a clear understanding of how to reduce this leakage or where and why it occurs in some cases.

A lot of health systems use the EHR system to manage and track their patient referrals and EHR’s can’t show why and where the patient’s left the network. However, efficiency in tracking and managing patient referrals still remains challenging.

HealthViewX HIPAA compliant referral management solution streamlines your end-to-end referral process and manages patient referrals better, improves patient satisfaction, reduces patient referral leakage and gives you clear insights of referral analytics for informed decisions. The best way to avoid patient leakage is to elevate patient experience and ensure you track each and every referral that comes in and goes out of network.

Schedule a demo with us and our patient referral management experts will guide you through our HIPAA compliant patient referral solution.

How to build a strong referral network for your medical practice

Health systems and hospitals need to build a high performing and strong referral network as they serve a large community. For most health systems, out-of-network providers/physicians are the main sources for new patients. Hence in today’s highly competitive healthcare market, it is crucial for the health system to build, strengthen and maintain these referral relationships to have a strong referral network.

A strong referral network would need patients, referring physicians and receiving providers to keep a healthy network going. A referral solution has the potential to build a strong referral network.

Here are some reasons as to why you need a solution to build a strong referral network

Health systems need to reduce referral leakage and ensure they don’t refer patients out of their network
Referral coordinators have to ensure timely scheduled appointments for their patients
Health systems need to reduce their no-show rates
Referral coordinators need to coordinate care between the internal and external providers for better patient outcomes.
Hospitals / Health systems need to create and manage a high performing referral network
To obtain more complete and detailed analytics to improve their patient inflow
Track patient status at every stage and ensure referral loop closure

Healthcare providers need to adopt healthcare IT and embrace interoperability. Therefore, the only way to build this strong referral network is to identify and implement the right referral solution for your practice.

HealthViewX Patient referral management solution can bring in the following benefits for the health systems and help strengthen your referral network

Reduced patient no-show rate
Reduced referral leakage
Increase operational efficiency
Patient satisfaction
Increased revenue
Streamlined referral life cycle management

Making small changes in the way health systems handle referrals will help to retain the patients within the network. Thus, retaining patients within the network, giving quality care will lead to better clinical outcomes. HealthViewX patient referral management solution acts as a bridge and enables seamless communication between the referring provider and the receiving provider. It helps in making meaningful decisions on the referral process thus making the change that the health system requires today.

Staying ahead in healthcare technology is imperative as it will bring massive benefits to the day-to-day operations and can empower the practice as a whole. A more streamlined process can lead to patient satisfaction, happier referral sources and patients thus making the network strong through quality care. Once the entire referral process is fine-tuned providers can fully focus on patient care and relationships with referral sources.

Optimizing referral management will help large health systems and hospitals improve overall efficiency and referral network. Data analytics feature will help providers to understand – the referral patterns, the highest referring source, the lowest referring provider, no-show rates, referral leakage, missed appointments, etc. HealthViewX works with each of its clients to understand their current challenges in the referral system and tunes the referral process to overcome these challenges and build a strong referral network.

HealthViewX patient referral management is highly customizable and is used by leading FQHCs, Large Hospitals, Dental Universities, and Specialities. Do you want to build a strong referral network?

Schedule a demo with HealthViewX referral management solution experts today!