Referrals
 Are the following questions and situations similar to what come up within your department?
- Is this member eligible and or approved?
- What percentage of referral requests can be processed without manual processing?
- Why isn't there a CPT code or a ICD-9 code on this referral?
- How do I get in touch with the doctor? I need the medical records to approve the referral.
- It's Dr. Jones on line 4. He says, "What fax?"
Did you know that:
- Faxed referrals are manually touched an average of 8 times prior to receiving approval
- Faxed referrals receive about 40 calls daily from patients regarding their referral status 200 minutes daily are wasted by each processor answering those 40 questions
We offer you this information at your fingertips to answer these questions and more!
Referrals Support
Solutions:
Referral departments can now:
- Have a real-time interaction for electronic, pre-filled referral forms, referral status, and member eligibility.
- Physician offices can automatically have approval and printing capabilities based on business rules.
- Obtain critical information needed with the 'forced field selection' feature.
- Receive notes between physicians and UM staff, as well as alert on overdue action-items.
- Automated e-mail notifications on status and changes.
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