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Referrals Orders being completed prematurely by Billing staff

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Last Post by gibsonmi 11 years ago

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Anonymous

(@Anonymous)

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Topic starter

We are having issues with or Referrals showing up in the Orders list of the Practice Management System (PMS) side of CPS and being unintentionally closed by the Billing staff. (they know to look for referrals in workflow but it still happens occasionally). Ideally, Referrals should be left open for the Referrals Coordinator to act on then complete. If they are accidentally closed then the Referrals Coordinator can't see them and must be recreated - laborious.

It makes sense that a referral should be an order on the EHR side for providers to create. But, It seems to me that referrals are not billable for us so should be able to exclude them in Orders on the PMS side to avoid issue of billing staff closing them incorrectly.

Does anyone know if this can be done as an Admin configuration or similar workaround?

thank you,

David

Posted : December 23, 2013 5:43 am

cecild

(@cecild)

Posts: 314

Reputable Member

We use the Referral orders and yes they are not billable.

Our workflow say for a CT in house is. Provider orders CT from the Referrals, it flags the Referral Cordinator (in an Admin Hold status) which then gets the CT scheduled and moves status to In Progress. Once the CT has been completed the billable order (Test/Service Order) is put in by the Imaging Dept. This then flows to billing. The Referral remains open until we get a report back into the EMR.

Hope this helps you,

Cecil

Posted : December 24, 2013 1:48 am

gibsonmi

(@gibsonmi)

Posts: 827

Prominent Member

David,

Go to codes and categories in admin and pick some of the categories and/or codes you are having issues with. Click change and see if there is "Insurance-specific information" on the order or category. If there is, select it and click change. There is a check box there that says "Transfer to Visit." If this is checked it will transfer to PM. By default all service orders transfer and tests and referrals do not.

Posted : December 25, 2013 11:00 pm

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