Cobblestone Family Health

[Insert Practice Name]

Referral Tracking Process

Purpose: To improve effectiveness, timeliness and coordination of care by following through on consultations with other practitioners.

1. The provider determines the type of specialist for the patient. Information from the provider will include type of specialist, diagnosis, urgency of referral, specialist name and phone number

1. Orders for referrals will be forwarded to the referral nurse by:
2. Written order
3. Verbal order
4. Electronic Medical Record

1. CFH referral nurse will attempt to schedule referral while the patient is still in the office for the appointment. If the patient prefers, the referral nurse will call them at home with the provider name, date, and time of the appointment.

1. Any information requested by the referral provider will be faxed along with orders and any insurance required prior-authorizations if applicable.

1. All orders will be signed and dated by the CFS referring provider (PCP) and then faxed to the referring provider. The order will then be scanned into the patient’s EMR and placed in the Orders section of the chart.

1. The referral coordinator will track referrals until specialist reports are received. Results of the referral consultation will be scanned into the patient’s EMR for the patient’s PCP to review. If a follow-up office visit is required after the results are reviewed by the PCP, the PCP will document this on the review and will instruct a care team member to contact the patient.

1. STAT/ASAP/Critical Referrals.
2. Provider will determine if a referral is to be done STAT/ASAP/Critical
3. Referral coordinator will call specialist and schedule appointment for patient.
4. Any required referral form for the patient’s insurance will be completed and faxed to specialist before patient’s appointment.
5. Referral log to be completed and flagged with a checkmark.
6. Referral Log
7. A referral log will be kept and updated daily with referrals given for the day
8. Date, Patient’s name and specialist name will be noted in the log
9. STAT/ASAP/Critical referrals will be flagged with a checkmark.
10. Consultations received for STAT/ASAP/Critical referrals to be logged in referral log with the date received
11. Lot to be reviewed weekly to make sure consultation reports are received in a timely manner
12. Spot checks will be performed on a quarterly basis to access the practice’s ability to meet this requirement 75% of the time.

Approval Date:00/00/0000

Review Date: 00/00/0000

PCMH 05B