Maximize your performance with Innovaccer’s Centralized Referral Team (CRT) application

Dr. Rohan Choudhari, Rakshay Jain
Mon 09 Aug 2021
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Referral management can be a powerful tool for health providers to track their patient referrals throughout the care continuum. Providers can maximize the potential of their referral management tools by referring to in-network providers, but the potential of these tools remains largely untapped.

In a rapidly evolving healthcare landscape, a lack of necessary information and broken workflows are impacting provider referral workflows and increasing the number of out-of-network referrals. As a result, most large-scale providers are struggling with:

  • A lack of operational efficiency: No comprehensive solution for referral coordinator team workflows
  • Network leakage: 10–20% of referrals are out-of-network
  • Missing specialist details: 87% of out-of-network referrals are a result of incomplete provider information
  • Patient unaware of referral status: 46% of faxed referrals never result in a scheduled appointment
  • Incomplete referral loops: 40% of patients that follow through with appointments don't inform their PCP

Given these challenges, many of our existing customers expressed interest in a solution that can improve referral flow, reduce leakage, and decrease the burden on PCPs. Our Centralized Referral Team (CRT) application is designed to help large provider networks centrally process and transmit all referrals.

How Innovaccer’s CRT application helps

The CRT application is designed to solve critical referral issues in the following ways:

  • Improving operational efficiency by:
    • Organizing and distributing work between coordinators with group-based access to worklists (faxes and referrals) and the option to search, sort, filter, and assign referrals
    • Creating and processing referrals easily with the ability to automatically fill patient and provider details, record referral information, record prior authorization numbers, and more
    • Receiving fax referrals and integrating fax workflows into worklists
    • Run real-time patient insurance verification using a third-party

  • Reducing network leakage and improving access to specialist details to help the coordinators:
    • Choose the right specialist by displaying in- and out-of-network providers filtered by distance, specialty, cost, and quality metrics

  • Improving operational efficiency by:
    • Choose the right specialist by displaying in- and out-of-network providers filtered by distance, specialty, cost, and quality metrics
  • Complete referral loops and keep patients and stakeholders informed by:
    • Tracking the status of each referral to ensure no drop-off at any step
    • Sharing referrals with patients, specialists, payers, and other stakeholders through email and fax

What’s coming soon for Innovaccer’s CRT application

  • Appointment booking: EMR integration enables easy appointment booking that works with providers’ schedules.
  • Prevention of duplicate documentation: Bidirectional syncing with EMRs allows easy referral orders and streamlines the flow of information from the CRT app into the EMR.
  • Automatic referral filling: TPAs run optical character recognition (OCR) on incoming faxes to prefill referral forms.
  • Referral prioritization: The application can automatically put a high-priority referral at the top of the worklist based on predefined rules.
  • Workflow simplification: The application gives care teams the ability to segment new referrals based on predefined business rules to identify the next steps, i.e. generate the right form layout, pre-selecting a specialist, etc.
  • Performance tracking: View coordinator performance, including the number of referrals processed, the status of referrals, the number of referrals completed, and more.

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Tags: Data Activation Platform
Dr. Rohan Choudhari, Rakshay Jain
Maximize your performance with Innovaccer’s Centralized Referral Team (CRT) application

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