Please take the time to read through the following points. Understanding and implementing the points below when carrying out a referral will help avoid headache situations for us and the patient.
- When sending a referral, always include important patient documents/records/notes in the fax. This is always true, but especially for MRIs/advanced imaging, and specialist referrals. We’ve seen a few patients turned away because they didn’t have supporting documentation to prove medical necessity. You may need to chart mine a bit to find relevant Amaze chart notes, and always look in the uploaded document section to see if the patient has old imaging, labs, external records that you can fax along with the referral. If you’re not sure, always ask the referring provider!
- Similarly, when sending referral for MRI or specialty imaging, please verify with the facility that the image has been approved by insurance before the patient’s appointment. Oftentimes they’ll require a prior authorization (which is not initiated until after the appointment is on the books) and the patient doesn’t find out that it is either still pending or not approved until the time of the appointment.
- Double triple check that the specialist you’re sending the patient to is appropriate for what is being requested in the referral. For example, when it comes to orthopedists, they all have subspecialties, so we want to make sure to send the patient with back pain to a spine specialist, not a total joint, or a knee specialist. If not sure, please ask referring provider.
- When sending patients for imaging, please call the facility to make sure they do the specific views and/or protocol requested. Especially if using radiology assist.
- Please verify with the facility that it is in network with the patient’s insurance. Don’t go off of a network search (you can start here but always verify with the facility)
- Please always upload outbound referrals to the patient’s documents so we can backtrack if needed.