Referral and authorization tracking

Purpose

1.1. Automate the collection, validation, tracking, and follow-up of patient referrals and insurance authorizations in the allergy and immunology specialty for efficient onboarding.
1.2. Ensure referral documentation and authorizations are captured from primary care or referring physicians, validated for completeness and compliance, and alerts created for expiring or missing authorizations.
1.3. Sync data with EHR, notify patients and staff, and manage status changes for seamless scheduling and insurance compliance.

Trigger Conditions

2.1. Receipt of new referral document via fax, email, or EHR integration.
2.2. Submission of digital referral form by physician portal.
2.3. New patient registration in clinic management software.
2.4. Staff upload of insurance authorization letter.
2.5. Automatic pull from payer/insurance portal API when scheduled appointment detected without completed referral.
2.6. Status update from third-party clearinghouse or payer.
2.7. Referral document status change in EHR or practice management system.

Platform Variants

3.1. DocuSign
• Feature: Envelope Sent/Completed webhook – triggers workflow upon signed referral/authorization received.

3.2. Twilio
• Feature: SMS API – automatically message patients about missing referral forms or status changes.

3.3. SendGrid
• Feature: Transactional Email API – send templated emails to referring physicians for incomplete info.

3.4. Google Drive
• Feature: "New File in Folder" trigger – monitors referral intake folders for uploads.

3.5. Salesforce Health Cloud
• Feature: REST API (Referral Object Create/Update) – capture, track leads from referrals.

3.6. Cerner EHR
• Feature: FHIR API (ReferralRequest, Authorization resources) – synchronizes system referral/authorization data.

3.7. Epic EHR
• Feature: Interconnect API (GetReferrals, GetAuthorizations) – triggers on new orders or missing authorizations.

3.8. Athenahealth
• Feature: Webhooks / API – monitor and push new referral and authorization records.

3.9. Microsoft Outlook/Office 365
• Feature: "New attachment in shared mailbox" – triggers referral extraction and processing.

3.10. Box
• Feature: Webhook on folder – initiates action on new or updated patient referral docs.

3.11. Smartsheet
• Feature: Row added/changed event (Referrals sheet) – workflow for incomplete, pending, or completed statuses.

3.12. Zapier
• Feature: Webhook or email parser – automate extraction and forwarding of referral data from multiple sources.

3.13. Jotform
• Feature: Submission trigger – patient or provider uploads referral form or insurance doc, feeds data pipeline.

3.14. HubSpot
• Feature: Deals/Custom Objects API – log referral as a deal/record for tracking communications.

3.15. BambooHR
• Feature: Documents API – keep HR and compliance documents in sync with onboarding records.

3.16. Trello
• Feature: Card created/updated in Referral Board – represents each referral for status tracking and team tasking.

3.17. Calendly
• Feature: "Event scheduled" webhook – triggers referral status check before confirming appointment.

3.18. RingCentral
• Feature: SMS/Voice notification API – sends automated alerts for authorization expiry.

3.19. Google Sheets
• Feature: Row added/modified – tracks intake progress, notifies staff on issues.

3.20. Slack
• Feature: Incoming Webhooks – alerts care team on missing or expired referral/authorization.

3.21. Redox
• Feature: Integration engine – normalizes healthcare data between EHRs and third-party sources, triggers referral updates.

3.22. Adobe Sign
• Feature: Signing Complete event – enter tracking for new digitally completed authorizations.

Benefits

4.1. Reduces manual tracking errors and compliance risk.
4.2. Accelerates onboarding and stops gaps in patient scheduling.
4.3. Centralizes data status and history for audits.
4.4. Automates reminders reducing staff workload.
4.5. Improves patient experience with proactive notifications.