Lesson 3: Epic Appointment Scheduling Referrals

Epic Appointment Scheduling Referrals In this lesson you will learn how to: Complete the Full Entry form Enter a referral with no expiration date Enter free text or coded diagnosis Edit the status of a referral Enter communications Enter referral note and review referral history Review linked records Print a referral

Referrals– Full Entry Full Entry (6 forms) General, Dx/Px (Diagnoses and Procedures) Authorization, Communication, Notes and Linked Records

Referrals General Form Key Information The General form window displays general information on the referral, including the type, referred by and referred to information.

Referrals General Form Key Information # of Visits Requested, Authorized Enter the number of Requested and Authorized visits in the designated field. If the referral has unlimited visits, enter the number 99. Click “Next” to proceed to the DX/PX screen.

Referrals– DX/PX’s DX/PX’s This form allows you to enter the Diagnoses and Procedures associated with a referral. You can enter free-text diagnoses and procedures or coded diagnoses and procedures in the designated fields. Click within the coded field and press F5 to search codes.

Referrals - DX/PX’s DX/PX’s Open the appropriate “coded” field with F5 and use completion matching to find the correct ICD-10 diagnoses. Highlight the appropriate selection and click “Accept”.

Referrals– DX/PX’s DX/PX’s If the procedure's on the referral are to be done at CHKD, please note it in the Procedure Free Text field of the referral. Most insurance companies require the location of the procedure. Click on “Next” to proceed to the Authorization screen

Referrals - Authorization The Authorization form of the window displays information on the coverages used for the referral and options for approving, pending, or denying the referral as well as the Authorization number.

Referrals - Authorization Click on “Approved” if authorized by the insurance coverage. Once this step is completed the referral status of Authorized is added you will be required to enter Start and Expiration dates before clicking Accept to complete the referral. If needed a reason can be added for the referral status. The coverage verification status displays in the referral entry. Verification Status

Referrals - Authorization Authorization Number The authorization number assigned to this referral by the insurance carrier for each coverage, if that carrier’s authorization is required for any of the procedures on the referral, enter free text. Only Alpha or Numeric characters should be entered in this field. Do not use special characters such as colons, comas, etc. If the referral has no expiration date, enter the date 01/01/2020. A warning will display if a referral expiration date is set that is before the linked appointment dates.

Communications Communications The Communications form displays documented information concerning the outcome of communication attempts for the referral. For example: an attempt to contact the patient, payor and or PCP that issued the referral. To add a communication click the Communication button.

Communications Communications The date and time will auto populate but can be changed if a note is not added to the referral at the date or time the communication was made. The Communication Form in the Referral can sort communication linked to the referral by their date and time. Clicking the ‘Date/Time’ column header to sort a referral’s communications.

Referrals - Notes Notes This form displays any notes associated with the referral. From this form you can add, edit, delete, and print notes. You can read notes by highlighting and clicking on the “Open” button. To create a new note, select the Type, enter Note and click Accept.

Referrals – Print Feature Print to Accept Selection of the “Print on Accept” checkbox will allow you to print a hard copy of the referral. The paper document can then be faxed to a provider who is not within the CHS system or to insurance companies when necessary. If you do not want the note on the printed referral check the Do not include in printed output box. Accepting will save all the information on this patient’s Epic record and will return you to the initial referral screen.

Referrals-Linked Records This form shows a list of appointments that are linked to the referral. The Linked Appointments list cannot be edited.

Referrals – Additional Button Features The buttons listed below are available from any form in the referral workflow diagram and can be activated by the mouse or the hotkey. Counts Activate the window to enter manual referral counts. Back Moves to the previous form in the workflow diagram. Next Advances to the next form in the workflow diagram. Accept Files the referral entries and closes the activity saving the information you entered. Cancel Exits Referral Entry without saving changes.

Epic Appointment Scheduling Referrals A completed referral can be viewed immediately by any other Epic practice. The patient is given instructions to make an appointment with the specialist (note: follow your practice policy). The Specialist can then view and assign the referral before making the appointment.

Epic Appointment Scheduling Referrals At the time the appointment is made, the appointment should be assigned to the referral. Epic will count down the number of times the patient has an appt to the number of referral visits authorized and will display a message when the number of appointments has been met. You can also enter a manual count against the referral for additional services provided such as a radiology exam.