Sending Referrals Out

purpose ensure that patient referrals to outside providers are completed accurately, promptly, and with all required documentation, so that continuity of care is maintained and delays in treatment are avoided when complete this process when the provider determines the patient needs to be referred to an outside specialist, facility, or other healthcare provider responsible role referral coordinator / front desk / clinical staff (according to office workflow) procedure step 1 receive referral order from provider obtain the referral order or referral request from the provider confirm the referral includes patient name date of birth diagnosis or reason for referral referred to specialty or provider name ordering provider name any urgency or special instructions clarify any missing information with the provider before continuing step 2 verify patient information open the patient chart in chirotouch confirm the following information is current and accurate full name date of birth address phone number insurance update demographics if needed before sending the referral step 3 confirm referral details verify the name of the outside provider, specialist, or facility confirm the referral destination fax number, phone number, or portal information confirm the reason for referral matches the provider’s order identify whether the receiving office requires referral form office notes imaging reports insurance card demographic sheet authorization additional records step 4 gather required documents collect all documents required for the referral include, as applicable referral order patient demographics insurance information recent office notes imaging reports test results medication list any supporting clinical documentation review documents to ensure they belong to the correct patient step 5 complete referral form fill out the outside referral form, if required enter patient name dob contact information insurance information referring provider name referred to provider/facility diagnosis / reason for referral relevant clinical notes double check for completeness and accuracy step 6 verify authorization requirements review the patient’s insurance for referral or authorization requirements determine whether prior authorization is needed if authorization is required obtain or request authorization per office protocol record authorization number if available do not send incomplete referral information if authorization is required unless office policy says otherwise step 7 send the referral send the referral packet to the outside provider using the approved method fax secure portal electronic system email, if approved and secure include all required documentation confirm the transmission was successful fax confirmation sheet portal submission confirmation electronic receipt, if available step 8 document the referral document in the patient chart that the referral was sent record date sent time sent destination provider/facility method used (fax, portal, etc ) reason for referral documents included authorization status upload or scan confirmation of successful transmission if applicable step 9 notify patient contact the patient to inform them referral has been sent provide name of preferred provider/facility phone number, if appropriate any next steps the patient must complete document patient notification in the chart step 10 follow up if needed monitor for confirmation that the referral was received, if required by office protocol if the outside office reports missing information gather the missing items re send promptly if the referral is urgent, follow up with the outside office directly document all follow up actions final check before closing the task, confirm patient information is accurate referral order is complete required records were included authorization was addressed referral was successfully sent documentation was completed in the chart patient was notified