Referrals

1.What is a referral?

• a request that a provider makes for a patient to receive some type of service

• a document that tracks patient trends

• Extra paper forms for healthcare

• A document that anyone creates to justify the visit

2.What are referrals used for? select the correct answers

• Tracking patient movement between physicians

• Documenting insurance approval for specific types of appointments

• Collecting preauthorization numbers for procedures before they are performed

• Meaningful use Data

what is the correct order of a referral in Epic

• Referral generates order>goes to providers office for scheduling>appointment is scheduled

• Order placed>generates referral> Referral goes through Asa>if referral is incomplete goes to incomplete WQ > after completing authorization referral goes to ready to schedule WQ >Appointment is ready to be scheduled

• Referral is manually created> goes to the providers office for scheduling> gets approval after being scheduled

• Referral generates with the order> provider authorizes specialty visit and procedure> consultation and procedure are scheduled

what are the 3 Referral classes?

• Internal Referral /Existing Referral /New Referral

• Specialty referral / Consultation Referral /Internal Medicine Referral

• Procedure Referral /Test Referral/Specialty Referral

• Internal Referral/ Incoming Referral / Outgoing Referral

why is a Referral important ? ( all that apply)

• Documents that the insurance company will pay for services (minus co-payment and /or share of cost )

• Ensures our organization gets paid for services

• Helps provider to advertise his services

• Ensures patient does not get a bill

when sending or receiving a referral for a procedure or test ,What is the best practice for our organization ?

• Provider Orders the procedure >referral is generated > referral goes through revision > appointment is scheduled

• Clerical Staff manually generates a referral > appointment is scheduled> Referral goes through revision