Referral Management

Overview

The referral management system allows you to create, track, and manage patient referrals throughout the intake process. Referrals can come from multiple sources including web forms, manual entry, and external systems.

Creating Referrals

Manual Referral Creation

1. Navigate to Intake Dashboard

   • Go to /admin/intake
   • Click the "Create Referral" button

2. Enter Patient Information

   • Patient name (first and last)
   • Date of birth
   • Gender
   • Contact information (phone, email)
   • Medical Record Number (MRN) - optional
   • Insurance information (type, provider, policy number, group number)
   • Reason for referral
   • Additional notes

3. Set Initial Status

   • New referrals are automatically set to new status
   • needs_eligibility_check is automatically set to true

4. Submit

   • Click "Create Referral" to save
   • The referral will appear in the intake dashboard

Web Form Referrals

Referrals can also be created through public web forms:

1. Form Submission

   • Patients or referring providers submit information through a web form
   • Form data is automatically converted to a referral
   • Referral source is marked as WEB_FORM

2. Automatic Processing

   • Referral is created with status new
   • Files uploaded with the form are attached
   • Intake metadata is stored for tracking

Filtering and Searching Referrals

Available Filters

The referral table supports multiple filtering options:

• Status: Filter by referral status (new, active, pending, etc.)
• Response Submitted: Filter by whether a response has been submitted
• Eligibility Check Needed: Filter referrals that need eligibility verification
• Eligibility Status: Filter by eligibility verification status
• Patient Name: Search by patient name (partial match)
• Referral Type: Filter by type of referral
• MRN: Search by Medical Record Number
• Date Range: Filter referrals created within a specific date range

Using Filters

1. Access Filters

   • Use the filter panel at the top of the referral table
   • Multiple filters can be applied simultaneously

2. Clear Filters

   • Click "Clear Filters" to reset all filters
   • Individual filters can be cleared by removing their values

3. Refresh Data

   • Click the refresh button to reload referrals with current filters
   • Data automatically refreshes after creating or updating referrals

Assigning Referrals to Care Teams

Assigning to Users

1. Open Referral Details

   • Click on a referral in the table to open the detail page
   • Or use the "Assign" action from the table

2. Select Care Team Members

   • Click "Assign to Care Team" button
   • Select one or more users from the dialog
   • Users are added to the patient's care team array

3. Confirm Assignment

   • Click "Confirm" to save assignments
   • Assigned users will have access to the referral
   • The care team list is updated immediately

Care Team Management

• Multiple Assignments: Multiple users can be assigned to a single referral
• No Duplicates: The system automatically prevents duplicate assignments
• Access Control: Only assigned users and admins can view referral details
• Updates: Care team changes are reflected immediately across the system

Referral Status Workflow

Status Types

• new: Newly created referral, awaiting initial review
• active: Referral is active and being processed
• pending: Awaiting additional information or action
• completed: Referral process is complete
• cancelled: Referral has been cancelled

Updating Status

1. From Referral Detail Page

   • Select the status dropdown
   • Choose the new status
   • Status is updated immediately

2. Bulk Status Updates

   • Select multiple referrals in the table
   • Use bulk actions to update status for all selected

Referral Details and Actions

Viewing Referral Details

1. Access Details

   • Click on any referral in the table
   • Opens the referral detail page at /admin/intake/[referralId]

2. Information Tabs

   • Overview: Basic patient and referral information
   • Eligibility: Eligibility verification status and details
   • Documents: Attached files and documents
   • History: Activity log and status changes

Available Actions

• Edit Patient Information: Update patient details
• Assign to Care Team: Add users to care team
• Update Eligibility Status: Mark eligibility as verified/not verified
• Submit Response: Submit decision response for referral
• Delete Referral: Remove referral (requires confirmation)
• Download Documents: Download attached files

Decision Making

Making a Decision

1. Access Decision Interface

   • Open referral detail page
   • Navigate to the "Decision" section

2. AI-Assisted Decision

   • Click "Make Decision" to get AI recommendation
   • System analyzes patient information and provides decision suggestion
   • Review the AI recommendation

3. Manual Decision

   • Select your decision (accept, decline, etc.)
   • Enter reason for decision
   • Optionally override AI recommendation

4. Submit Response

   • Review decision and reason
   • Add optional comments
   • Click "Submit Response" to finalize

Best Practices

Referral Creation

• Complete Information: Enter all available patient information at creation
• Accurate Insurance Data: Ensure insurance details are correct for eligibility checks
• Clear Referral Reason: Provide detailed reason for referral
• Attach Documents: Upload relevant documents at creation time

Referral Management

• Regular Review: Review new referrals daily
• Quick Assignment: Assign to care team promptly
• Status Updates: Keep referral status current
• Documentation: Add notes and comments as needed

Workflow Efficiency

• Use Filters: Leverage filters to focus on specific referral types
• Bulk Actions: Use bulk operations for multiple referrals
• Keyboard Shortcuts: Learn keyboard shortcuts for faster navigation
• Notifications: Enable notifications for new referrals

Troubleshooting

Common Issues

Referral Not Appearing

• Check filters - referral may be filtered out
• Verify organization access
• Refresh the page

Cannot Assign Users

• Verify user permissions
• Check that users belong to the same organization
• Ensure referral is not in a locked state

Status Not Updating

• Refresh the page
• Check for error messages
• Verify you have permission to update status

Documents Not Uploading

• Check file size limits (typically 10MB)
• Verify file format is supported
• Check network connection

Related Documentation

• Eligibility Verification
• Patient Intake
• User Roles and Permissions