Referral Management Software

Vendor that can provide a closedloop referral management solution capable of tracking referrals from creation through final resolution, including scheduling, completion, consultation receipt, and communication back to the originating provider.
- The vendor shall provide a comprehensive, referral management platform that supports the complete lifecycle of outbound specialty referrals, diagnostic imaging facilitation, including
referral intake, authorization management, specialist scheduling status monitoring, consultation retrieval, referral closure, analytics, and interoperability with Epic.
• Electronic receipt of referral receipt with Epic integration that does not depend solely on fax
• Duplicate referral detection and prevention
• Prior authorization management
• Closed loop referral management with Status monitoring and alerts from received, scheduled, completed
• Specialist consults note retrieval with PCP notification upon referral completion and automated closure workflows of specialty orders
• Platform build, set up and onboarding. Ongoing onboarding and software support for end users and role-based users
• Bi-directional communication ability with ordering provid
- Epic Integration and Interoperability
• Proven Epic integration experience.
• HL7 and FHIR API’s support
• Referral order synchronization for one time entry of referral order and processing with patient demographic synchronization such as MRN, Provider, specialty requested, referral priority, diagnosis codes, insurance information, and supporting documentation.
• Consult note retrieval into Epic.
• Appointment status monitoring: scheduled, did patient attend, was it canceled, outreach efforts.
• Real-time interface monitoring
- Analytics and Dashboards
• Monthly reporting includes system uptime, downtime, ticket response, and resolution
• Full support for real time data and dashboards and analytics with ability to customize for required data.
• Full unrestricted access to referral management data for meta-analysis
• Referral Processing volume, aging, completion rates, closing the loop compliance, leakage.
• Ability to see scheduling conversion rates, no show rates.
• Specialist performance metrics
• Authorization turnaround times
• Time to appointment metric, wait times.
• Urgent referral compliance tracking
- Patient Engagement Capabilities
• SMS reminders
• Automated patient outreach
• Multilingual communications
• Monitoring failed outreach attempts