Managing referrals and authorizations
MDoffice fully integrates referrals in its scheduling, registration and checkout functions, tracking treatments allowed and services performed. The software records incoming and outgoing referrals, including the number of authorized visits and charges for each visit. You learn which referrals are bringing in revenue and which are not. And you can send custom letters to patients and doctors.
MDoffice separates three kinds of referrals: from Primary Care Physicians (PCPs) to specialists; referrals received by specialists, and referrals from PCPs to special facilities. Referrals can include the chief complaint or problem, diagnosis, or present fully detailed care plans. MDoffice can provide levels of authorization, and allows you to design custom referral forms with narrative instructions.
Outgoing referrals.
Primary Care Physicians (PCPs) can issue and send outgoing referrals to other physicians containing referral number, insurance plan, authorization code, number of visits, cost, service period, diagnosis, procedures, doctor and specialty requirements.
Some insurance carriers limit referrals to specialists, so the PCP must determine if a patient has any allowed visits remaining or any money left to pay for them. The specialist receiving a referral can see the remaining dollar amounts, number of allowed visits, the start and end dates of the referral, and other relevant information.
Referrals are comprehensive, including the name of the referring physician, original diagnosis and treatment procedures. They are easy to enter, with clearly listed limits and numbers of authorized, used and remaining visits. This lets you know if a referral is connected to an appointment and if sufficient visits remain on the authorization.
When an insurance provider or HMO limits the number of visits, MDoffice automatically updates the remaining number of visits and the dollar amount available. When a patient checks in, the software recalculates the remaining number of visits.
Incoming referrals.
If you’re a specialist, MDoffice records incoming referrals and tracks the allowed number of visits for those patients. When you book appointments and enter charges and payment, the system displays your comments. MDoffice maintains basic referral information including expiration dates, number of visits authorized, plus services allowed and rendered.
Contract Management
Capitation Management