How are referrals handled?

tekknogenius wrote on Thursday, April 14, 2005:

What are people doing for referrals? If the Dr. has to give a refferal slip to a patient, how is that recorded in OpenEMR? Are referral slips different for each insurance company?

drbowen wrote on Thursday, April 14, 2005:

Currently we are dong this on paper.

We would like to have a form that includes fields that show:

To whom we are refering: Doctor, hospital, lab, radiology office
    as a text field

Patient Name: fname, mname, lname

Identifying info such as: DOB, SSN, pt phone number

What is the referral for: consultation or the name of the test

The ICD diagnosis or symptoms that prompt the referral
   text box for descriptive diagnosis and a field for the ICD
   code(s)

Text box: for comments on special features or requirements

The Hospitals like to have a statement certifying that I as the physician believe this is medically necessary (for CMS).  Of course some of the referrals are "screening" or cosmetic and would not need this disclaimer.

A box that the insurance company was contacted with the date, name of insurance clerk, and approval status.

A signature graphic for the practitioner or some over electronic signing mechanism.

Date and time of the test.

We actually make the referral first and then get insurance authoriztion afterwards.

Some referrals need special forms filled out before we are allowed to scedule the test.  A case in point: MRI  we have to certify that they have none of the known absolute contraindications like metal foreign bodies etc.

Inclusion of special instructions to the patient like "Nothing by mouth after midnight. "

We copy the form and let the patient hand carry a copy and we fax the form to a receiving physician or institution.

The form should include the Practice name/logo, telephone #, fax # and mailing address.

drbowen wrote on Thursday, April 14, 2005:

We also have a separate MS Access database used to track outstanding diagnostic testing/referrals.  This includes:

datetime of the referral
datetime of the test
Institution or referral physician
test description/consultation
A short description of the test result
datetime of the report
datetime of patient notification.

A test is visible on the list until the patient is notified of the result. When there is a datetime stamp on patient notification the referral is excluded from the query. 

If the patient no-shows or cancels this is entered in the test result field and a datetime is placed in the last field. The ordering practitioner is notified of the no-show or cancellation for follow up.

tekknogenius wrote on Thursday, April 14, 2005:

So, something similar to the presriptions would work, right?

drbowen wrote on Thursday, April 14, 2005:

Yes

emilykillian wrote on Friday, April 15, 2005:

There is a section in OpenEMR labeled "transactions." That appears to be the place where a referrals section was started.

I would classify it as rudimentary, at best.

Hope that helps…

emilykillian wrote on Friday, April 15, 2005:

To clarify, "transactions" is in the top row and is located between "Encounter" and "Documents."

tekknogenius wrote on Friday, April 15, 2005:

I saw that, but it doesn’t do anything except notate on the patients record that a referral was requested. You can’t print it, so the patient won’t have anything to brign with them to the referred doctors office.