Managing Referrals Sent from CityMD to Mount Sinai Health System: Special Considerations

When CityMD staff process referrals in par8o, they select from three urgency levels: 

• Stat - patient needs to be seen ASAP
• Urgent - patient needs to be seen in 1-2 days
• Routine - patient needs to be seen within 28 days

These statuses dictate where the referral is sent at MSHS, and also how long the receiving party has to act on a referral by using the Contact/Schedule action before the referral is escalated to CityMD’s call center known as Aftercare.

It’s important to note that until a referral is complete, all parties will be able to view the referral in their Work Queues - however, the party that has taken the first action is responsible for completing the referral. This means that you may see people you don’t recognize taking action on the referral and calling the patient. 

By following and understanding the steps outlined below, you can better understand which party is responsible for and has access to each referral based on the urgency and activities taken.

Processing Stat Referrals

1. CityMD referral coordinators schedule the appointment directly with the receiving MSHS provider office before sending the referral in par8o.
2. The referral is sent via par8o as  “scheduled” with the appointment date and time and will display in the Received tab.
   
   Note: If a Stat referral is sent without scheduling information, it should be processed as if it is an Urgent referral. 

Processing Urgent Referrals

1. Referral is sent via par8o to the MSHS Physician Access Services (PAS) work queue, bypassing the receiving office’s “Required Review” tab.

   Note: The referral may be viewed by the receiving office in the  “Received” tab and will display a tag to indicate it is being managed by PAS.

2. If the Contact/Schedule action is not logged in par8o within 30 minutes of receiving the referral, the referral will escalate to CityMD’s AfterCare work queue and AfterCare staff will begin to work on the referral.

   Note: All parties will be able to see the referral in their Work Queues until the referral is complete.

3. If MSHS PAS staff do not log an appointment on the referral within 6 business hours of receiving the referral, the referral will escalate to CityMD’s AfterCare work queue and AfterCare staff will begin to work on the referral.

Note: The location that takes the first action is expected to complete the referral. For example, if CityMD AfterCare contact the patient before PAS, CityMD AfterCare is expected to complete the referral, and vice versa. Please also note “viewing” a referral does not count as an action. 

Processing Routine Referrals

1. Referral is sent via par8o directly to the MSHS receiving office staff. 

2. If the receiving office staff do not use Contact/Schedule to log a patient contact attempt within 4 business hours, the referral is escalated to the PAS team and appears in the PAS work queue.

Note: All parties will be able to see the referral in their Work Queues until the referral is complete. If an appointment is not logged in par8o within 24 business hours from the time the receiving office receives the referral, the referral is escalated to CityMD AfterCare and will appear in the AfterCare work queue. 

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Urgency	Referral Originally Sent To	Escalated To CityMD Aftercare When...	Escalated to MSHS PAS When...	Notes
Routine	Receiving MSHS Office	No appt scheduled in system within 24 business hours	No actions logged within 4 business hours	Viewing a referral does not count as an "action".
Urgent	MSHS PAS	No actions logged in 30 minutes during business hours	N/A	Viewing a referral does not count as an "action".
Urgent	MSHS PAS	No appt scheduled within 6 business hours	N/A	If contact/schedule has been used and patient contact attempts have been made but an appointment is not logged within 6 hours, the referral is still escalated to Aftercare.
Stat	Receiving MSHS Office	N/A	N/A	Stat referrals are scheduled via phone to confirm immediate availability before the referral is sent in par8o. Referrals are sent in par8o as "Scheduled" with time and date of patient appt.

Note for management: These workflows only apply to referrals going to employed MSHS providers.