Tag Archives: referral

How Can Dental Centers Improve Their Patient Referral Workflow?

Did you know? In a year, 15 billion faxes are sent out for referrals 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 is a high inbound referral setup. They need an effective referral management solution to manage the increasing inbound referral rates.

Existing Patient Referral Management Workflow in a Dental Center

A typical dental center or dental group is a high inbound patient referral setup. Dental centers receive volume of referrals weekly (ranging from 50 per week to even several hundred per week) depending on the number of patients visiting the center and 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.

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

  • The dental center loses its revenue when referrals are not processed in time.
  • Providers stop referring the center thereby harming its reputation.
  • Patients may have severe illness and may need immediate attention. The waiting time may affect their health.

Challenges faced by a Dental Center

  • Referrals flow into the dental center through various channels like fax, online forms, direct messaging, email, virtual print, direct walk-ins, etc. A dental center has no specified source to receive referrals.
  • The dental center receives numerous referrals which are difficult for them to process. This is because there is no single system to consolidate and manage referrals
  • There is no tracking system to understand in which stage of a referral life cycle is any referral is in.

Let us review a typical referral process to elaborate 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.
  2. 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 his condition and problems to him. This is time-consuming for the specialist as he wastes time on the same information twice.
  3. 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.
  4. 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 know understand the analytics of his specialty.

HealthViewX Patient Referral Management solution at your aid

Patient Referral Management is complicated not only by the different sources but also by trying to manage all the referrals manually. The current referral management is no way close to the increasing demands of the referral process. Its inability to communicate between the referring and the receiving ends makes it slow and non-feasible.

Considering the challenges faced by dental centers, an Electronic Referral Management Software can help them better. After the complete analysis of a dental center’s referral workflow, HealthViewX realized that the crucial part of the problem is the lack of a system to consolidate referrals. On further analysis of their process, HealthViewX Patient Referral Management solution introduced the following features to meet their requirements,

  • Multi-Channel Referral Consolidation – Referrals flowing in through many channels are consolidated in a single interface. It enables easier monitoring and facilitates timely referral loop closure.
  • Referral Tracking – HealthViewX gives a clear picture about how a referral has progressed with the help of a timeline view. Every referral has a status which 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.
  • 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 application is a secure source for sending and receiving referrals. Also documents can be attached and sent as a referral.
  • Referral Data Consolidation – It has options for printing the consolidated data about the referrals and the referral history of any patient as a hard copy at any time in PDF/excel.
  • Secure Data Management – HealthViewX Patient Referral Management is HIPAA compliant. It manages all patient-related documents securely.
  • Referral Analytics – Helps in tracking the number of referrals and gives complete information about the referrals processed, missed, scheduled etc with the help of a Referral Data-centric Dashboard.

HealthViewX Patient Referral Management solution helps dental centers in managing their referral network and increasing their revenue. Are you a dental center looking to track your inbound referrals very effectively? To know about HealthViewX Patient Referral Management System in detail schedule a demo with our team.

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 Hospitals Improve Their Patient Referral Management By Complying With Meaningful Use

What is meaningful use?

Meaningful use (MU) is a health information technology (HIT) term that defines minimum U.S. government standards for

  • Using electronic health records (EHR)
  • Exchanging patient clinical data between health care providers, between health care providers and insurers, and between healthcare providers and patients

It has a set of rules known as meaningful use measures or meaningful use criteria. It determines whether or not a healthcare provider receives federal funds from the Medicare EHR Incentive Program, the Medicaid EHR Incentive Program or both.

Almost 99% of the hospitals in the U.S. use EHR systems. It is a huge leap by EHRs compared to 31% of hospitals back in 2003. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users. While an EHR does contain the medical and treatment history of patients, an EHR system is built to go beyond standard clinical data collected in a provider’s office and can be inclusive of a broader view of a patient’s care. EHRs can:

  • Contain a patient’s medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory and test results
  • Allow access to evidence-based tools that providers can use to make decisions about a patient’s care
  • Automate and streamline provider workflow

Impacts of EHR on Care

Electronic Health Records create a greater and more seamless flow of information within a digital healthcare infrastructure. It encompasses and leverages digital progress and transforms the care delivered. With EHRs, hospitals experience improved,

  • Patient Care and participation
  • Care Coordination
  • Diagnostics and Patient Outcomes
  • Practice Efficiencies and Cost Savings

Three stages of Meaningful Use (MU):

Meaningful use is divided into three stages.

Stage 1, which began in 2010, focused on promoting the adoption of EHRs.

Stage 2, finalized in late 2012, increases thresholds of criteria compliance and introduces more clinical decision support, care-coordination requirements and rudimentary patient engagement rules.

Stage 3, which the CMS is writing from late 2014 through early-to-mid 2016, will focus on robust health information exchange as well as other more fully formed meaningful use guidelines introduced in earlier stages.  

What are the incentives and penalties for meaningful use?

Under the HITECH Act enacted under the 2009 Recovery Act, incentive payments are available to eligible professionals who successfully demonstrate meaningful use of certified EHR technology.

The Recovery Act specifies three main components of meaningful use: The use of a certified EHR technology

  • In a meaningful manner
  • For electronic exchange of health information to improve quality of healthcare
  • To submit clinical quality and other measures

According to Medicare and Medicaid EHR incentive programs, the practices receive incentives if they meet the meaningful use requirements. If they do not meet the meaningful use requirements, they will be penalized.

Medicare EHR Incentive Program

Medicare incentive payments are equal to 75% of a practice’s annual Medicare Part B allowed charges up to a maximum yearly amount.

After 2015, providers who were eligible for the Medicare Meaningful Use program but did not successfully demonstrate Meaningful Use were penalized. The penalty started at 1% of Medicare Part B reimbursements and increased each year to a maximum of 5%.

Medicaid EHR Incentive Program

In the case of Medicaid patients, a practice can earn up to $63,750 in incentive payments over the six years that they choose to participate in the program.

If you start in 2015, you can earn incentives through 2020. Practices can consult their state’s agency for information about a specific payment schedule.

Providers who are eligible for Meaningful Use under the Medicaid program are not subject to payment penalties unless the provider is also eligible under the Medicare program.

How can a Patient Referral Management Referral Management enhance an EHR system to achieve meaningful use?

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

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.

HealthViewX Patient Referral Management solution provides easy steps to integrate with a practice’s EMR/EHR system. It also enables easy and safe transferring of patient demographics, diagnostic reports, test results or any sensitive information. The solution is HIPAA-compliant with complete data security.

HealthViewX can enhance a practice’s EHR capability by making it achieve meaningful use. The practice’s scoring can also improve by using HealthViewX Patient Referral Management solution.

HealthViewX Patient Referral Management solution features

It has the following features,

  • Inbound and 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.
  • Referral Timeline – Any referral has a timeline, to capture the progress of the referral. It is common to the referring and receiving provider. 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.
  • 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.
  • Improved communication – HealthViewX Referral Management Solution supports messaging and calling features for the referring and the receiving providers to stay connected.
  • Data Management – The solution is HIPAA compliant and enables secure data exchange of all patient-related documents.
  • 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.
  • Referral Data 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.
  • Smart Search – HealthViewX Referral Management solution has a smart search facility that helps in finding the right provider for the treatment required.
  • Referral Data Analytics – Referral data-centric dashboard gives clear figures regarding the number of referrals flowing in and 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

https://www.healthcare-informatics.com/news-item/ehr/survey-nearly-all-us-hospitals-use-ehrs-cpoe-systems

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.

How Can A Hospital Tackle Their Operational Problems With The Help Of A Software?

Hospitals are crucial in giving care to patients who come to them with various problems. With increasing health problems, the number of patients visiting the hospital is also increasing. As per the survey by Statistics Portal, Community hospital expenses per inpatient stay in the U.S has been increasing. Are hospitals doing enough to manage the increasing number of patients? Many hospitals are still managing their process and workflows manually. So what challenges do they face in handling such huge patient data and process manually?

Challenges faced

Let us a scenario based example to understand the challenges better. James is suffering from a headache for the past two days. He thought it would get better if he takes rest but it only became worse. He realized that he was running a high temperature and decided to visit the doctor.

  • The patient is trying hard to fix an appointment with the doctor – James had heard about a famous doctor nearby. Nothing was mentioned online about their opening or closing hours or if they were working today or not. Luckily he found the contact details. James calls up the doctor. The line was engaged. It was a holiday so many patients were trying to reach the clinic. He tried for half an hour before his call got connected. By that time most of the appointments were booked for the doctor. James finally got a slot to meet the doctor at 4 pm. This did not go well with James as he was already suffering from a severe headache. He felt that the hospital must have some means of scheduling appointments without any hassle during busy days.
  • Patient waiting to visit the doctor – James reached the clinic at 3.30 pm. He thought that his visit would be fine as he had already booked an appointment. He was surprised by the crowd. He found that there were ten more patients before him waiting to visit the doctor. He was not happy with the clinic as he had to wait for one more hour to visit the doctor. Why should he wait even after having booked an appointment? He regrets choosing this clinic as his headache is getting worse. The clinic had nothing interesting like magazines or tv to while away the time. That one hour of waiting was really bad for James. After meeting the doctor, James felt better. He finally came out of the clinic at 5.30pm after getting his medications.
  • Patient engagement – The clinic does not collect patient feedback about their visit to their health. James was looking for something like a feedback to make the clinic aware of his concerns. It seemed like they were too busy to hear him out. He went out of clinic thinking to never return to this place.

It is obvious that James is going to tell some other friends and family about his bad experience in this clinic. The chances of patients visiting the clinic after listening to him are less.

The above were the challenges faced by patients. But what challenges prevent the clinic from meeting the patients’ expectations?

  • Appointment scheduling – The clinic has an outdated method of fixing appointments over phone calls. There are no systematic methods of collecting patient requests and processing it as appointments. There is an extent to which appointments can be managed manually. When the number exceeds and when managed manually, it leads to patient dissatisfaction and also affects the workflow of the clinic.
  • Patient no-show ratesMany patients do not show up for appointments. The reason can be anything. The patient might have forgotten, visited another doctor or might have got better. There is no way of tracking which patients did not show up and why. The patients do not get reminders of the appointments which is an important reason for the increasing no-show rates.
  • Remote patient monitoring – There is no chance for the patient to get in touch with the physician in case of an emergency. Physicians are usually busy and are not available to patients for support. Though they are busy, it is good to make them available to the patients. It might be a case of emergency and the doctor’s advice might be crucial in that case.

How can a Software help in solving the challenges in the healthcare industry?

With the above-mentioned challenges, it is not good for a practice to manage its workflow manually. This is when Information Technology can help. Many physicians are skeptical about the cost a software will incur. They are not aware that healthcare software can solve their challenges and thereby reduce manpower. HealthViewX solution has the best features that can easily solve the problems of any practice.

  1. No change in the current process – The HealthViewX solution can be integrated with EMR/EHR and can write data of referral into any system if required. It is almost zero deviation from the current workflow a practice is using.
  2. Appointment scheduling and management – The HealthViewX solution has an application for the patients. They can conveniently fix appointments with the doctor depending on the schedule. The application also gives timely reminders to the patient and the physician about the appointment. It reduces patient no-show rates, patient waiting time and patient leakage. It has a positive impact on the workflow and patient’s experience.
  3. Electronic Care Plans – The solution enables care plan creation. It helps in monitoring patient’s vitals, measurements, etc. If required, it can also be printed and handed over to the patient. This feature is in order to keep the patients engaged and encourage them to stay healthy by adhering to the care plan.
  4. Audio and Video Calling features – It has an inbuilt audio calling and messaging application which is secure and enables faster communication. In case of an emergency, the patients can easily contact the doctors.
  5. Patient Reported Data – Patients can record data for all attributes in the care plan. Summary graphs and table data helps the provider in monitoring the patient’s vitals. The patient medical records can be anytime printed in pdf or excel report form.
  6. Health Device Integration – HealthViewX 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.
  7. Report Consolidation – The data regarding the patients’ health attributes can be printed as a report anytime in pdf/excel form.
  8. 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.

HealthViewX software solves most of the challenges faced by the practices. It increases the revenue and efficiency reduces manpower. Do you want the solutions HealthViewX offers in detail? Schedule a demo with us.

 

References

https://www.statista.com/statistics/459772/community-hospital-expenses-per-inpatient-stay-in-the-us/

 

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.