Automating Referral Management: 3 Areas to Streamline

Does your current referral management process bring up feelings of burnout, frustration, or just general annoyance?

If you’re nodding along, you’re not alone. Even though we know how important an efficient and effective referral management process is to patient care, it’s often easier said than done. When it’s done right, healthcare organizations see better patient care coordination, patient satisfaction, resource utilization, and healthcare outcomes. But, where should you start?

At Valer, we believe automating your referral management process is the key to seamless healthcare. In this blog, we highlight the challenges with traditional processes and share three areas to prioritize with automation to get the most out of your referral management strategy.

The Challenge with Non-Automated Processes

If you’re still trapped in the world of non-automated referral management processes, you’re likely navigating ongoing faxes, phone calls, and emails. When your organization relies on paperwork like this, you’re more prone to unnecessary care delays, which disrupts scheduling and patient access to crucial services.

Without an automated system, your staff has to jump in to manually submit and process referrals. This outdated, time-consuming approach eats up valuable resources and contributes to backlogs and inefficiencies.

Recent data shows that the average patient appointment wait time is up 8% since 2017 and 24% since 2004. Today, it takes around 26 days for a new patient to get on the calendar with a provider. While other factors come into play (like a growing shortage of physicians), delays in referral processing exacerbate the issue.

Lastly, these paper-based, manual processes lack real-time visibility into referral status and checking, making it more difficult for your team to monitor referral status progress and intervene when necessary.  

The Solution: Automated Referral Management

With automated technologies, healthcare organizations can now revolutionize their referral management processes, benefiting both providers and patients alike. Equipped with these tools, you can say goodbye to backlogs and hello to increased staff capacity. Here are three key areas where you can streamline referral management with automation and eliminate the frustrations associated with manual referral tracking. 

1. Streamlined Referral Initiation

First things first: getting the referral ball rolling. Initiating a referral is the first step in connecting patients with specialized care beyond the scope of primary care. Without the support of automated technology, the process can be a headache of paperwork and phone calls. With automation, you can initiate referrals in a snap, cutting down on administrative hassles and getting patients the help they need faster.

Automated solutions like Valer streamline the referral initiation workflow. Healthcare organizations can significantly reduce administrative burdens by providing technology solutions for primary care physicians to generate referrals and automate authorization requests.

This facilitates a quicker, streamlined transmission of referral requests to specialists or diagnostic facilities, ensuring timely access to specialized care for patients. Additionally, automation facilitates seamless communication between providers, enhancing collaboration and improving patient outcomes. 

2. Efficient Prior Authorization Management

While referrals and prior authorizations serve different purposes, they can be related in certain situations. For example, a referral to a specialist may require prior authorization from the insurance company before the specialist visit or procedure can be covered. In such cases, the referring provider may need to obtain prior authorization approval before the patient can proceed with the recommended specialty care.

By automating your referral management process, you can simultaneously simplify your prior authorization management by integrating clinical and administrative data, streamlining communication between healthcare providers and insurance companies, and providing real-time verification capabilities.

By leveraging EHR systems and payer portals, automated referral management systems facilitate the seamless transmission of referral information, clinical documentation, and prior auth requests, minimizing errors and reducing administrative burden on healthcare teams. A win, win.

3. Enhanced Care Coordination

Effective care coordination is essential for delivering high-quality, patient-centered care across different healthcare settings and specialties. However, manual referral management processes often lead to communication gaps, delays in information exchange, and fragmented care delivery.

Automated solutions like Valer address these challenges by facilitating seamless communication and information sharing between referring and receiving providers. By automating referral workflows and enabling real-time access to patient records, diagnostic results, and treatment plans, healthcare organizations can enhance care coordination, improve patient outcomes, and optimize the patient experience.

Additionally, automation enables the tracking and monitoring of referral status, ensuring that patients receive timely follow-up care and reducing the likelihood of missed appointments or care transitions.

Automate Your Referral Management with Valer

The case for referral management automation is compelling, with significant benefits for healthcare organizations, providers, and patients. What you’d lose in manual, error-prone workflows, you gain in greater referral process visibility, time savings, and care access.

Automated solutions empower healthcare organizations to deliver more efficient, cost-effective, and patient-centered care. As the healthcare industry continues to evolve, embracing these technologies will be essential for optimizing referral management processes, reducing administrative burdens, and driving positive outcomes for all stakeholders involved.

At Valer, we are committed to partnering with healthcare organizations to improve coordination and reduce patient care delays. Ready to see how Valer can slash your organization’s referral processing backlogs? Contact us today.