Overview

When your team is identifying a specialist for an outbound referral, the platform can help narrow provider options based on factors like specialty and location. It does not currently include a built-in, real-time payer network directory that automatically verifies whether a specific specialist is in-network for a patient's insurance plan. Because of that, outbound referral matching depends on the referral knowledge your organization maintains internally.

What this means for your team

• Provider suggestions can be guided by specialty and geography.
• Insurance acceptance and in-network status should be based on your organization's maintained referral information.
• The accuracy of referral matching depends on how current and complete that internal information is.

For the most reliable results, keep an up-to-date list of preferred referral partners and the insurance plans they accept. This can be maintained in your organization's knowledge base, provider records, or contact notes.

Best practice

Maintain a standardized referral partner knowledge base document that includes the provider or organization name, specialty, service area or location, accepted insurance plans, and any referral preferences or scheduling notes. Keeping this information current helps your team make faster, more accurate referral decisions.