In EHR Software, Medical Data Entry

How To Improve Patient Care Through A Digital Patient Referral Process

Patient referrals are an essential aspect of every medical practice. Sometimes a patient needs more specialized treatment, so your referral is crucial to that patient receiving the care they need. However, without a digital system, your referrals may be lost or forgotten.

Referrals written on a business card or sent through a fax machine are likely to misplaced in one way or another. In fact, 68 percent of specialists receive no information from the primary care provider (PCP) prior to referral visits. This is an ongoing problem, especially for specialty care providers.

In part, specialty care providers need referral information to understand the patient and the level of care they need. On the other hand, referrals must be approved by insurance companies to ensure the care needed is complete and correct. When this information isn’t accurate and complete, approval from the insurance company is delayed, further impacting patient care. This is why a seamless and digitized referral process is necessary.

Specialty practices aren’t the only ones who stand to benefit from a digital referral system, though. Many practices rely heavily on giving and receiving patient referrals. After all, the more easily patients can be referred to you, the better.  

If patient referrals are a weak spot for your practice, there is a solution. In this blog, you’ll learn:

  • The benefits of digitizing patient referrals
  • The importance of a seamless digital patient referral process
  • How a referral and authorization management system can improve patient care and the referral process

5 Ways A Fully Digital Patient Referral Process Can Benefit Your Practice

1. Reduce excessive amounts of paperwork

An electronic referral process can eliminate the excessive amount of paperwork around your practice—we know you deal with enough of that already!

As we mentioned before, many providers choose to send referrals through fax or written on a piece of paper or a business card. These items are easily misplaced, and a fax may just be another piece of information lost in the day-to-day shuffle.

A digital referral process, however, will not only make it easier for you, but also for the specialized provider to access and locate critical patient information.

2. Increase the likelihood of a scheduled appointment

If you struggle with patient referrals, it likely doesn’t come as a surprise to you that only 50 percent of patient referrals result in a scheduled appointment. While this partially falls on the patient to schedule an appointment, the blame largely falls on a poorly managed referral system.

When referrals are digitized, there is less of a chance for lost, misplaced or forgotten information. The more streamlined the referral process is, the more likely your insurance provider is to approve the care. Thus, resulting in more patients scheduling appointments. After all, more patients mean more revenue for your practice.

3. Save critical time for your medical staff

While the time it takes to send a fax or give a handwritten note may seem trivial, it only detracts from the limited amount of time your physicians already have. However, a digital referral system has the ability to save time for every member of your medical staff.

Instead of leaving the room to send a fax, a physician can simply complete an online referral in a matter of seconds, while the patient is still in the room. This saves critical time, while simultaneously building a stronger patient-provider relationship. Additionally, when receptionists are unable to locate patient information quickly, they have to spend lengthy amounts of time on the phone to gather patient information. This amount of time can be significantly reduced with a digital referral system.

4. Improve overall accessibility

At its essence, a digital referral program is easier to use and access. Not only does it save time for the primary care provider, but also for the specialty providers. Entering information and sending the referral is quick while accessing and viewing that information on the other end is much less of a hassle.

With an electronic referral system, patient information is just a click away. You won’t have to worry about sorting through paperwork, or locating missing patient data.

5. Gain complete patient information

Speaking of missing patient data, one of the biggest issues PCPs and specialty providers face is the lack of complete and correct patient information. Not only does this require more time from your staff to locate this information (through phone calls, additional searching, etc.), but it causes a larger issue in terms of patient care. Without a complete and correct referral, the insurance company cannot confirm that the care is necessary.

This impacts patient care in a big way! It requires additional effort from your staff to correct the error or collect the information. Mistakes or holes in a patient referral can be easily avoided, especially through a digital referral system. By requiring certain fields, you can gain peace of mind knowing that referrals will be complete. This will cause fewer complications for you, the insurance company and the patient involved.

Learning the benefits of a digital patient referral process is important. But you also must understand the necessity of streamlining the patient referral process. Let’s dig into that a little deeper.

The Importance Of A Seamless Digital Patient Referral Process

Going digital can help your practice in more ways than one, especially when it comes to patient referrals. However, if you’re not used to operating within a digital system, then you may not be aware of best practices to streamline the process.

If your referral process isn’t seamlessly implemented, then your practice is bound to experience complications and pushback from the insurance provider. Let’s walk through that process together to make sure we’re on the same page.

A brief example

In this example, let’s say a patient is visiting their PCP. During their visit, the PCP determines that specialized care is needed and requests to make a referral to a specialty provider. The PCP must then submit that request to the insurance provider to determine if a formal request is required—for instance, if the specialty care is outside of the patient’s health plan network. If the patient’s information is correct and complete, the insurance provider will approve the referral, allowing the patient to schedule an appointment with the specialty provider.

Additionally, and dependant on the type of care that is needed, the PCP may also need to submit an authorization request. These requests are for specified ancillary services only, and request requirements will once again be determined by the insurance provider.

Patient referrals and authorizations work hand-in-hand, which is why it’s crucial to have a streamlined process in place for both of them. However, during the referral or authorization process, it’s easy for requests and approval to be delayed due to a lack of intentional management. This is when it pays off to invest in an authorization and referral management system.

Is It Time To Invest In An Authorization And Referral Management System?

Are you ready to streamline your digital patient referral process and maximize proficiency within your practice? If so, it’s time to invest in an authorization and referral management system.

However, not just any system will do. Any investment made by your practice should be strategic, and with a company or service you can trust. Just like we said at the beginning, patient referrals are an integral part of the success and functionality of your practice. The more you are able to improve this process, the more your practice stands to benefit.

When you need a company with services you can rely on, look no further than DataMatrix Medical.

DataMatrix Medical’s Authorization and Referral Management Solution

At DataMatrix Medical, we have devoted our careers to developing multi-faceted solutions that address your practice’s needs while helping you grow. It’s our mission to identify and solve the daily complications you face, which is why we offer authorization and referral management as one of our many solutions.

We provide customized referral and authorization management solutions that can work within your current practice management system. Our experienced staff understands referral and authorization systems as well as record requirements and strategies, so we can help you gain timely approvals while saving your practice money.

Our services won’t interrupt or derail your current practice management system either. Instead, we can seamlessly supply the correct patient data into your system. This will not only improve the timeliness of approvals but also maximize productivity within your practice.

Don’t let patient care suffer due to a poorly managed authorization and referral system. Trust our team and solutions to improve patient care and elevate your current processes. To learn more about our solutions, don’t hesitate to contact us. We are ready to answer any questions you may have! Plus, we can create a customized solution to the daily struggles your practice faces.


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