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The Referrals tab on the Insurance Maintenance window enables you to enter one or more referrals for the patient's insurance. For example, when a patient's primary care provider refers them to a specialist for a specific procedure, the specialist may need to obtain a referral from the payer prior to performing that procedure. The referral number provided by the payer can be entered in NextGen® Enterprise PM, so it is included on claims sent by the specialist to that payer for the referred procedure.
A Push Pin icon on the tab indicates one or more referrals exist for the patient's insurance.
Existing referrals are listed with the following information:
When a referral is entered for the insurance before an encounter is created, it automatically attaches to a new encounter that meets all criteria defined within the referral.
When a referral is entered for the insurance after an encounter is created, you can manually attach it to an existing encounter that meets all criteria defined within the referral. This is done from the Patient Chart , Encounters tab, Insurance sub tab, and Verification section.