The Referral Connection
This part of a referral includes the patient's name, date of birth, and contact information.
What is the patient’s demographic information?
These are terms to describe this, stat, urgent or regular.
What is a type / status of referrals?
These types of referrals should be closed within 90 days of
What are Medicare referrals?
This term describes the healthcare professional who sends the patient to another doctor.
What is a referring provider?
Following up on this aspect ensures the patient attended their specialist appointment.
What is appointment confirmation or follow up call?
This information should be sent to the specialist prior to the appointment to ensure proper care.
What are medical records or referrals?
A standardized set of procedure codes utilized in healthcare to represent medical, surgical, and diagnostic services and procedures performed by healthcare professionals, thereby supporting effective medical billing.
What is a CPT Code?
A joint federal and state program that provides health coverage to eligible low-income adults, children, pregnant women, elderly adults and people with disabilities.
What is Medicaid?
Clinical personnel will enter this when a patient needs to see a specialist.
What is a referral?
A list of referrals, orders, encounters, etc. that need some sort of follow-up
What is a workqueue?
A place to document authorization from an insurance company for services, or a way to track patient movement from physician to physician.
What is a referral in EPIC?
0-7 days
30 days
60-90 days
What are referral touches?
At least 2 attempts need to be made to contact the patient, and the patient has not called back to confirm or schedule an appointment
What is Closing the Referral
A Combination of letters and numbers that represents a specific medical condition, procedure, symptom, or disease.
What is a diagnosis code?
It is called this once the referral has been fully addressed, and no further action is required, the referral can be considered closed.
What is closing the Loop or closed referral?
The referral specialist must do this after the referral information has been sent to the receiving practice.
What is updating the referral status and documenting in the communication section.
A referral is placed here if insurance is pending, the providers notes are incomplete or more information is needed.
What is the Pending Referral Work queue?
This is the number of attempts a referral specialist must make to contact a patient for scheduling.
What is 3 attempts?
This type of referral is needed when a patient must see a specialist within 24 hours due to an urgent medical issue.
What is a stat / urgent referral?
This important action ensures that all referral processes are complete and documented properly.
What is closing out the referral in the patient’s record?
This is the final step in closing the loop for a patient that you were unable to contact after 3 attempts.
What is notify the referring provider and document the notification?
After 2 attempts to contact the patient have been made, a final letter sent and a message to the care team.
What is closing the referral?
What is Care Everywhere?
These are the 3 locations you go to in order to schedule an appointment from a referral.
What is Appointment Desk, Referral Tab and Schedule from Referral?
Four important pieces of information sent with a referral to an outside provider.
What is Demographics, Insurance & referral information, last office visit note and Medication list.