We are happy to announce several key enhancements to the Inbound Referrals feature that will be rolled out in stages over the next several months.
- Referrals Screen Enhancements
- New System Defaults
Note: As a part of the referral enhancements, we have removed the Recalculate button from the Referrals screen.
Referrals Screen Enhancements
We have updated the Referral screen with the following functionality:
- Carrier and Provider Information icons – We have added new Referring Provider and Carrier information icons to the Referrals screen so that you can quickly view master file information for the provider and the carrier.
- Include Referral Information on Claim check box – We have added an Include Referral Information on Claim check box to allow you to control what provider and NPI referral information is sent on a claim. The check box is selected by default.
Important Note: Clear the Include Referral Information on Claim check box to use the Self-Referral provider name and NPI on the claim.
- Referral Appointments Report button – We have added a new Referral Appointments report that includes a list of all appointments associated with the referral. To view the report, click the Ref Appts button.
New System Defaults
As a part of the new enhancements, you can choose to set up all referrals based on several system defaults to calculate referral usage by minutes as well as visits, and set up referral warnings. See the System Defaults help file for more information on setting up referrals in your system.
Go to Utilities | System Defaults | Appointments.
Referral Calculation System Defaults
We have added new system defaults for calculating referral usage for all new referrals.
Note: You can override the system defaults for an individual referral, by entering referral calculation settings on the Referrals screen.
Update Authorizations using System Default
Indicate how referral authorization balances are calculated in the system:
The default is Visits.
Calculate Authorizations at System Default
As referrals are used by the patient, the system updates the referral balance and displays it on the Referral screen.
- Visits – If you calculate using Visits, indicate whether you want the system to calculate referral balance:
- When a visit is Scheduled
- When charges for a visit are Posted
- Minutes – If you calculate referrals using minutes, the balance is always calculated when a visit is posted.
Authorizations Minutes Per Unit System Default
Set the number of minutes that equals one unit when calculating referral authorizations by Minutes.
The default is zero.
- Enter a value in the Authorizations Minutes Per Unit system default field to calculate authorization balances using Minutes.
- If you choose to calculate referral usage by minutes, you must add a procedure code to the referral on the Referrals screen because the procedure code includes the unit measurement required in order to calculate minutes used.
Referral Warnings System Defaults
We have added new system defaults to set up referral warnings that automatically apply to all new referrals. Set referral warnings to alert you when a referral is expiring for a patient, and choose to have it display in EHR.
- PM – Referral warnings are triggered when a patient with an expiring referral is selected in Appointment Scheduler.
- EHR – Referral warnings are triggered when a new note is added to a patient chart for a patient who has an expiring referral.
Note: You can override the system defaults for referral warnings, by entering referral warning settings on the Referrals screen.
Auth Warning with Remaining System Default
Indicate how many remaining visits, minutes, or days trigger the referral warning message.
The default setting is zero.
Note: Leaving the setting at ‘0’ prevents the alert message from displaying.
Display Expiring Authorizations in EHR System Default
Choose whether you want to display referral warnings in EHR.
The default is No.
Rooming History Summary
Use the Rooming History report as needed to track the time patients are in each room as they move through their visit. The summary rooming report calculates the average time patients spend in each room and status, and a Minutes from Threshold value that indicates the difference between the actual time spent in the room and the threshold set for time in that room. The report can be filtered by appointment date range, facility, and provider.
Report Filters and Settings Section
This report has the following filters and settings:
- Appointment Date
- Provider Profile
Report Results Section
This report returns the following data for the filters and settings selected:
- Minutes from Threshold – The difference between the average threshold value set on the visit and the average time patients spent in the Rooming Status.
Note: The threshold is set in the Rooming master file as a default value for the status. The user can change that value for each visit. The threshold value used in this report is the threshold set on the visit, not the master file value.
- Rooming Status – The rooming status reported on this line.
- Room – The room the patient was in. The report results show each unique combination of Room, Rooming Status, and Appointment Type as a separate line item.
- Provider – The provider assigned to the visit.
- Facility – The facility where the visit occurred.
- Column – The column the visit was scheduled in.
- Appointment Type – The Appointment Type of the visit.
- User – The user who ran the report
Go to Report Center | Appointments | Rooming History.
Video Training Library (PM/EHR)
The following videos have been added to the Video Training Library:
- Application Performance Update (5:31)
- Coming Attractions Summer 2017 (4:57)
The following videos have been updated in the Video Training Library:
- Clinical Messaging (3:55)
- Referrals (10:23)
- Chart Files (7:18)