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Flagging an Insurance Carrier that requires the patient to have a referral

CPS, C-EMR, PM

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[email protected]

(@dcambiousnellc-com)

Posts: 18

Eminent Member

Topic starter

Hi CHUG Community,

Is there a way to flag an insurance carrier that requires a patient to have a referral alert the staff when the patient is accessed to make an appointment? I see in the Insurance Carrier there is a box that can be checked that says "Authorization Required". Is that intended for indicating a referral is required? If so does it send an alert or show up anywhere in registration?

Right now we are putting a popup in the patient's alerts in registration but that seems a bit redundant to have to do this for every patient with the same insurance carrier. If the person registering the patient fails to do so and the patient comes in without a referral. Either we see the patient and not get paid or we turn the patient away and reschedule for when there is a referral. Either one of these options is not good. Thanks,

Posted : February 23, 2018 3:15 am

valerie.smith

(@valerie-smith)

Posts: 12

Active Member

You can add an alert to the insurance carrier in Administration. There's an Alert Notes field. Enter any notes you want to display when you open a patient account with this carrier as an active carrier.

Posted : February 23, 2018 5:39 am

lkeith

(@lkeith)

Posts: 457

Honorable Member

We looked at the Alert Notes at the carrier level, however, we found an issue with Carriers where just one plan required a referral and we didn't want to end up flagging every patient when it didn't apply carrier wide. We finally decided to use the Patient Appointment Notes on the Appointment tab. When the office is booking the appt, they will see it in the booking window.

Posted : February 23, 2018 7:31 am

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