Referrals/Requests Management

Explain it to me in 15 seconds…
MMEx includes a referral management worklist

• Facility level list shows all referral records created for your organisation
• Patient level list shows all referral records created for that specific patient

Referral records in these lists are required if you undertake any specialist billing where referral details need to be sent to Medicare. The lists can also be used to track and manage incoming referrals and record the outcome of outgoing referrals.

Where a referral is created by or sent to an MMEx user, they will receive a secure message advising them of the outcome of the referral, including a request for more information or additional documentation.

Using the “Create Outgoing Referral” option:

• you can use a letterwriter template of your choice
• referral record creation is included in the letter creation process
• you can send your referral to the referral recipient or another MMEx user - perhaps the person that manages referrals at your organisation- via secure message
• you can select your referral recipient by:
  • searching for their name
  • filtering by a specialty group and then selecting the named user
  • you can also refer to a specialty and add the named person at a later date - this is especially useful when referring to departments where one of many providers may deliver the service requested.

Specialty group categories are applied to users in their user profile and as categories when entries are added to the address book.
Templates can be made to display in the referral templates list by selecting “Is referral” in the template management page.

The facility level Referrals/Requests management page is accessed from the Facility side menu, and is located in the Worklists sub-section.

The worklist allows you to keep a record of external and internal, incoming and outgoing referrals that are made by and to service providers.

The Referrals/Requests worklist can be used a number of ways. Options include:

1. tracking referrals received and sent
   • for activity reporting
   • recording outcomes
2. as a demand management tool for specific services or providers

There are two action buttons to:

• Create New Referral
• Add Incoming Referral

Across the top of the screen you will see a range of filters:

• Keyword Search field
  • Select from filter to search Patient, Requester or Type
  • Click Search to start the search and clear to clear the filter.
• Status
  • Filter the display by the assigned status of the referral
• User filter
  • Filter the list by the whole organisation or by a single user
• Current/Archived
• External / Internal
  • External - referrals recorded as being from or to Address book entries or users from other MMEx organisations.
    • Includes Pathology and Radiology requests - as referrals for investigations
  • Internal - referrals recorded as being from or to MMEx users within your organisation

Referrals will have a defaults applied based on who the referral is addressed to or referred from. The rules are based off user accounts and address book entries:

Firstly select the category of Referrals/Requests you wish to view - Internal or External.

Then select the tab for the type of referral record that you wish to see - Incoming or Outgoing.

You can then use the filters to refine your list to find a specific referral record.

In a number of locations in MMEx you will have the ability to record a referral entry.

Wherever you see the button, click on Add Incoming Referral.
This allows referrals to be added where a letter or form has already been completed/received from external sources.

Complete the Referral information, remembering to select Incoming or Outgoing as relevant and record the Date Referred.

Referral End Date will auto populate based on the type of referral selected. Be sure to give the document a specific and easily identifiable name so it can be located in the documents list at later date if required.

Click Add.

The referral will now be listed in the Referral list in the patient record and also in the facility referrals worklist.

When messaged are received with a request for referral, a referral entry can be added from Messages:

When adding to the referral work list through 'Add as Incoming Referral, any attachments will automatically add to the referral entry. Add the information relevant to the referral for tracking on the work list:

After selecting 'OK' the referral is entered onto the work list at the patient and facility level.

Once a referral record has been sent (see here) it will display in this list.

To track the progress or outcome of referrals sent to an external agency, select Category - External and then the Outgoing tab.

If the referral recipient is an MMEx user, any response that they record on the received referral will be sent to the referrer as a secure message and the status will be updated automatically. If the referrer is not an MMEx user, you can record the referral outcome as a response, right click on an entry and select Record Response In the response record, record the information you receive back from the referral recipient about whether the referral was

• accepted (Accept),
• rejected (Reject)
• needs additional information to be provided (Revise) or
• if you recalled or cancelled the referral (Withdraw)

You can record a comment that will display in the response column.

To keep your lists accurate, when a referral no longer requires any additional actions i.e. it is complete, right click and select Archive. The record will be retained, but will not display as part of the current worklist as an item requiring action.

Once a referral record has been recorded it will display in the worklist and on the patient level Referrals/Visits tab.

To process referrals received from external sources, select .
The referral can be changed from the default on Incoming Referral by selecting Outgoing.\\

To record a response, right click on an entry and select Response.
In the response record, record whether the referral was accepted (Accept), rejected (Reject) or needs additional information (Revise).

You can record a comment that will display in the response column and be sent to the referrer in a secure message to advise them of the referral outcome.

To keep your lists accurate, when a referral no longer requires any additional actions i.e. it is complete, right click and select Archive. The record will be retained, but will not display as part of the current worklist as an item requiring action.

When a patient has seen a Specialist, the referral needs to be attached to the Medicare account at the time of billing to ensure that the claim is paid.

To do this, enter the Billing Screen. On the Add Visit page, with your specialist provider selected, click on Advanced Visits Options to reveal the referral selection field.

From the drop down menu select Referral.

You may record the referral details here, however, if an existing referral has been recorded for the patient click on the Use Existing Referral button.
You will see a list of current referrals.

Click on the correct referral for this visit and provider. The details will populate the fields.

Continue with the Billing as per usual.