Customer Use Cases

Benefits for all size organizations, from private practice to the enterprise

Accurate information for personalized, value-based care

In a world of value-based care, healthcare providers must understand the full picture of the patient’s health so they can manage costs and risks while delivering high-quality, personalized care. For providers and payers alike, having the patient’s health conditions accurately and completely coded is crucial to appropriate payment for care delivered and risks shared. With ReferralMD, you can track the complete life-cycle of the referral and exchange data in real-time with all community providers regaurdless of their EMR.

Accurate information for personalized, value-based care

Deliver the personalized experiences today’s prospects and payer members expect

Health insurance payers must think beyond open enrollment and guide members along journeys throughout the year. Acquiring new members, Onboarding and engagement tools, building mutual advocacy, automating member journeys is what we do best at ReferralMD. We can help promote providers with the best outcomes using our decision support technology which ranks doctors on a variety of qualitative and quantitative data scorecards.

Deliver the personalized experiences today’s prospects and payer members expect

Deliver faster, better quality care for patients

  • Stakeholders:

    ACOs/CINs, Dentists, FQHC, Health Systems, Hospitals, Payers, PCPs, Pharmaceuticals
  • Solution(s):

    Patient Access Tools

ReferralMD sends messages to patients according to their communication preferences (e.g. telephone, email, or text message). These messages can include appointment reminders, pre-appointment paperwork, driving instructions, and follow-up messages.

Deliver faster, better quality care for patients

Prevent denials and receive decisions sooner

  • Stakeholders:

    ACOs/CINs, Dentists, FQHC, Health Systems, Hospitals, Payers, PCPs
  • Solution(s):

    E-Consult Management

Submit and track all your prior authorizations electronically through a single platform. You will no longer need to fax or call health plans.

Prevent denials and receive decisions sooner

Reduce “No Show” referrals and your malpractice risk

ReferralMD tracks the entire life-cycle of the referral process from referral intake, prior authorization, to progress updates with referring providers while improving capture rates and reducing no-shows patients.

Reduce “No Show” referrals and your malpractice risk

Decrease lead times

Operational inefficiencies in the medical workplace lead to bottlenecks in the care continuum. Dead time or unnecessarily long lead times are an inconvenience to both patients and providers alike and can lower customer service scores.Investing in a referral management solution can help save time, automate referral workflows, and improve processes that your health organization can control.

Decrease lead times

Visibility into competitors’ referral patterns

Most referral management software is focused solely on improving communication among providers and patients. However, a solution like ReferralMD also offers network analysis and helps identify competitor referral patterns.

Visibility into competitors’ referral patterns

Enhance provider and health system communication

A referral management solution is even more important for those providers under a health network umbrella. Many ACOs are built on value-based care models and thus, require an integrated communication solution so that they can maintain the quality of care that is standard to them.

Enhance provider and health system communication

Improve patient access

Improve customer service with your patients and allow them to have the power to schedule appointments themselves directly from your website.

Improve patient access

Reduce lost referrals due to improper handling, poor workflow, or antiquated e-fax technology

  • Stakeholders:

    ACOs/CINs, Dentists, FQHC, Health Systems, Hospitals, Payers, PCPs
  • Solution(s):

    SmartFAX Management

ReferralMD wraps modern day workflow technology and task management around our fax management solution, never again will you ask, who received the fax?, have they uploaded it to the EMR?

Reduce lost referrals due to improper handling, poor workflow,  or antiquated e-fax technology

Connect different EMRs using ReferralMD as the bridge for interoperability

With ReferralMD’s Interoperability Solutions (APIs, HL7, Direct Message, FHIR Integrations) we can solve your communication and workflow challenges with other providers no matter what EHR you use.

Connect different EMRs using ReferralMD as the bridge for interoperability

Improve visibility of provider affiliations across the network and reduce leakage

Intelligently direct patients to affiliated, in-network, high-quality providers with every care transition. Secure access to clinical summaries, coordinate authorization of service, engage patients before they choose a provider by displaying patient-specific real-time outcomes data for in and out-of-network providers.

Improve visibility of provider affiliations across the network and reduce leakage

Close the feedback loop, improve loyalty, and increase revenue from referring providers

For every care transition, discharge patients to the best available continuing care provider, securely transmit clinical summaries and updates to in and out-of-network care providers, generate compliant patient choice lists, and send/receive automated real-time notifications on patient status, appointment times.

Close the feedback loop, improve loyalty, and increase revenue from referring providers

Triage and match patients with the best providers with clinical decision support checklists

We replace inefficient, often paper-based workflows with transparent scalable workflows. Ability to label different referral ‘status’ within each journey stage and see where bottlenecks are occurring in real-time. Customizable workflows can be created for every care setting, no matter the specialty, department, or location.

Triage and match patients with the best providers with clinical decision support checklists

Provider directory capabilities for your public website and call centers

  • Stakeholders:

    ACOs/CINs, Dentists, FQHC, Health Systems, Hospitals, Payers, PCPs, Pharmaceuticals
  • Solution(s):

    SmartMATCH Decision Support

Offer care coordinators up-to-date information on every provider via a robust provider directory on your website or internal call centers before a referral is made including experience, clinical guidelines, specialty, sub-specialty, conditions treated, procedures offered, cost/quality data and network affiliations.

Provider directory capabilities for your public website and call centers

Acquire and retain patients with provider relationship management software (CRM)

  • Stakeholders:

    ACOs/CINs, Dentists, FQHC, Health Systems, Hospitals, Payers, PCPs, Pharmaceuticals
  • Solution(s):

    Marketing CRM

Easily track referral volume, notes, messages, meetings, tasks, and call logs in one location for provider contacts and patients so your team always has the most up-to-date information in one place to improve relationships and drive revenue. Assign marketing reps/physician liaisons to potential referral sources and track their activity and outreach with reports showing referral volume generated for all the referral partners associated with them.

Acquire and retain patients with provider relationship management software (CRM)

Communicate with online messages and e-consults versus fax or phone-calls on hold

E-consult Management can help:PCPs reduce the need for unnecessary referrals. Specialists improve customer service with referring providers. Payers direct patients to the most appropriate, high-quality provider in their network.

Communicate with online messages and e-consults versus fax or phone-calls on hold

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