At times, however, your queue may appear differently from your staff, or the queue might even appear different from one staff person to another. Why? This could be due to several reasons:
- The staff people have different provisioning, which means they are provisioned to manage referrals for different locations. This can be checked and fixed from Office Admin -- in this case, you'd want to edit the user's settings by copying the provisioning from another staff profile.
- The staff has used the "Archive" feature (Select Action>Archive), which only works on his or her individual queue. For example, some users may archive Declined referrals, which will move the referral to the Archive tab and it will no longer show on any of the other tabs (Requires Review, Sent, Received).
Work Queue tabs
To begin, let's review the various tabs at the top of the Work Queue:
- Requires Review - A "smart list" of all referrals that require action by your staff.
- If you are a sending office, this will include draft and declined referrals. A draft referral has not yet been sent to the receiving office. A declined referral is a referral that has been declined by the receiving office for one of several reasons.
- If you are a receiving office, this tab will include pending referrals. It will also include in progress referrals if the staff had set a callback reminder when logging the patient call. You may also see referrals in a Follow Up status. Follow Up is not used by all par8o clients.
- Sent - The sent tab includes all referrals that either will be or have been sent from, your office. The reason I mention "will be" sent from is because the tab includes draft referrals, as well as other outgoing referrals. Once a referral is in completed status, it is automatically moved to the Archive tab by par8o.
- Received - The received tab includes all referrals received by your office, excluding completed referrals.
- Archive - The archive tab includes all completed referrals as well as manually archived referrals.
- A completed referral is either a referral that has completed the referral lifecycle, meaning the time and date of the appointment has passed, or -- in the scenario where the receiving office is not online with par8o -- automatically completed 15 days after the referral was sent to the receiving office.
- A manually archived referral is any referral that has been manually archived by selecting Archive from the Select Action menu on the Work Queue. This action only works on the individual's Work Queue. Referrals can be "unarchived" from the Archive tab if they were manually archived by accident.
Best Practices for Managing Referrals on the Requires Review tab
The "Requires Review" tab should, by default, include all referrals that you or your staff need to take action on.
Scenario: Referral is in "Draft" Status
Recommended Action: Review referral clipboard (history/notes), "Finalize" the referral, send to receiving provider.
A referral may be in draft status either because the staff has yet to process it, or because it was created in error and staff has not yet discarded the referral. If the staff has yet to process (finalize) a referral, it might be due to staff waiting for par8o to add a new provider to the database. If this is the case, staff could have used the notes to add a note to the referral describing the reason for the wait.
Finalizing, or sending the referral to a receiving office/specialist, can be accomplished by selecting Finalize from the Select Action menu.
If the staff created the referral in error (e.g. accidentally selected the wrong insurance or specialty ), they may have left the draft in the queue in favor of a new or updated referral. If that's the case, you should use the search function to determine if a similar referral was sent to a receiving provider and/or communicate with the staff person to determine why the referral is a draft. If the referral was created in error, you may discard the referral by selecting Discard from the Select Action menu.
Scenario: Referral is in "Declined" Status
Recommended Action: Review referral clipboard (history/notes), then "Reassign" the referral to a new provider or make a note "OK to Archive" and manually archive the referral.
Declined referrals should either be "archived" or "reassigned" depending on the reason for the decline.
If a referral was declined due to patient-indicated reasons, e.g. patient indicated he or she would not attend the referral appointment or the patient did not return several phone calls; then you should first consider communicating with the referring care provider to determine if he or she would like to follow up with the patient. If so, leave a note via the referral clipboard/history to describe the status of the referral while the referring provider communicates with the patient. If not, leave a note on the referral "OK to Archive" so that your staff knows it's OK to archive this referral in their personal Work Queues. Then, archive the referral by going to the Select Action menu and selecting Archive.
If the reason for the decline is something like the patient's insurance was not accepted, the reason for referral was outside of the receiving provider's specialty, the receiving provider is not accepting new patients, and so on, then you or your staff should reassign the referral to a new provider by going to the Select Action menu and selecting Reassign. At that point, par8o will walk you through the same process as Finalize by presenting a list of recommended providers. Please make sure not to send the referral back to the same original provider.
If you prefer, you can leave a note asking the staff to reassign the referral by making a comment on the referral clipboard. Please note, some staff may be accustomed to hiding/ignoring/archiving declined referrals, so you may need to communicate a process change to your team.
Scenario: Referral is in "Pending" or "In Progress" Status*
Recommended Action: Staff should continue attempting to schedule an appointment with the patient and/or decline when required.
*Applies to offices that receive referrals only
If a referral is Pending or In Progress, it means the referral appointment has not yet been added to par8o. This is either because no appointment has been made, or the staff has not entered the appointment via using the Contact/Schedule tool.
To add an appointment, staff should go to the Select Action menu, select Contact/Schedule, and follow the on-screen prompts.
If a referral is Pending, it means a patient contact attempt has not been logged in par8o. This is also accomplished using the Contact/Schedule tool. Staff should select "no" when answering "Were you able to schedule an appointment" and then choose a call outcome. When staff clicks Save, it will change the status to In Progress until an appointment is logged.
Scenario: Referral is in "Follow Up" status
Recommended Action: Staff should choose "Log Appt Outcome" from the Select Action menu and follow on-screen prompts.
*Applies to offices that receive referrals only
If your office receives referrals from certain clients, once an appointment date that was logged in par8o has passed, the referral moves to a "Follow Up" status. To complete the referral, staff should select Log Appt Outcome from the Select Action menu and record whether or not the patient attended the appointment by using the on-screen prompts.
FAQs
How should uninsured patients be handled?
When the staff creates or finalizes a referral, they should make sure to select "Self Pay" as the option on the Select Payer pop-up window.
How should patients with Medicaid Pending status be handled?
Select Medicaid as the insurance plan, but make sure to note in the Reason for Referral box that the patient's Medicaid status is pending so the receiving office is properly informed.
How should actions be documented?
Any and all actions taken on the referral are automatically logged on the par8o referral clipboard, which you can access by clicking "View" on the referral in the Work Queue. If there are other actions that took place outside of par8o, staff can add a note by using the notes field at the bottom of the clipboard. Staff at both sending and receiving offices can see all notes added to the referral.
Will a referral come back to the Requires Review tab?
If you are a referring office, a referral will only return to the Requires Review tab if the receiving office declines the referral. Otherwise, it can be located on the Sent tab, or by using the Search fields to the left of the queue. After the referral is completed, it is automatically moved to the Archive tab. If you are a receiving office or call center, referrals will appear on your Requires Review tab when they are Pending, In Progress, or Follow Up -- In Progress referrals will appear on Requires Review if staff set a callback reminder when logging the prior call to the patient.
If the referral is being worked on by the receiving office, is it still available in my/my staff's Work Queue?
Yes, on the Sent tab. It will not, however, appear on your Requires Review tab unless the referral is Declined.
My practice currently uses a one-way integration with par8o. How will my providers know the status of the referral?
If they like, they can have provider par8o accounts, which gives them access to all of their patient referrals. However, you can also ask staff to update the record in your EMR if you wish.
Why is my queue different from my staff's or why is my staff's queue different from another staff's?
Your staff may have manually archived some referrals using the Archive function. Or, you or your staff may have different provisioning, meaning perhaps they are set up to manage referrals for fewer providers and/or locations than other people.