Submit Referrals
New Referral profiles have a status of In Progress. The In Progress status indicates that the Referral has not yet been authorized to receive service by a Payer. Note that the process of submitting service requests to a Payer is handled outside of HHAeXchange. However, users may maintain a record of the submission status within the system.
Complete the following steps to track Referral submissions.
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Go to the Referral Info page in the Referral’s Profile and scroll down to the Submissions section.
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Select the Contracts the Referral’s case was sent to on the Submitted To dropdown. On the Submission Date, indicate when the case was sent out. By default, the Status dropdown is set to Submitted. Agencies may edit the Status as responses are received, users can change the value to reflect whether it was Rejected or Accepted.
Click the Add button to create additional records if the Referral is sent to multiple Contracts.
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Set a Follow-Up Date to review the progress of a Submitted Referral. This date may be used as a filter when searching for existing Referrals.
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Click the Save button to finalize.
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Once a record is saved, the Submission Status History displays at the bottom of the Submission section.
Users can save a Contract by entering the Submitted To field without having to enter the Submission Date field. The system captures incomplete fields in the Submission section as N/A in the Submission Status History section.
When a referral submission is Accepted, the system generates a date field in the new Service Start Date column which is required to convert the Referral to a Patient. The Service Start Date also populates in the corresponding Service Start Date in the Patient Contract page under Patient > Contract.
The system does not allow the conversion (from Referral to Patient) if no date is entered in the Service Start Date field.
An ID Number column in the referral Submission table captures an identification number for the Program or Payer the referral is submitted to. This field accepts alphanumeric characters with and is available for all Agencies.
To enable this field, go to the Agency Profile under Admin > Agency Profile and select the ReferralID Numbercheckbox under the Required Fields section. Selecting this option ensures an ID number is required for referral Submissions.
