Do the following to submit a referral history inquiry:
- Right-click and select Referral History from one of the defined access paths.
The
Provider Referral Inquiry appears.
- Complete the following required fields:
- Patient Insurances
- Requesting Physician
- Complete the optional fields:
- Requesting Location (leave blank)
- Referred To
- Entity Type
- Code Qualifier (leave blank)
- ID Code (leave blank)
- Reference Code Qualifier (leave blank)
- Reference ID Code (leave blank)
- Notes (not sent to payer but displays on response - 255-character limit)
- Select OK.
The inquiry is now being processed. The progress bar at the bottom of the dialog box displays under
Ready to Submit. When the submission is complete, the system displays the response in the
Referral Result window. View the Transaction Details, Service Provider Details, and Subscriber Details.
Note: Scroll-down and view additional information; for example, Services Detail and procedure and diagnosis codes, and benefit dates.
- To print a copy of the eligibility response for your records select the print option.
- Select Close.
Note: Each time an inquiry is submitted and a response is received, a significant event is logged. When a response is received, a Chart Note is recorded under Referral Results with the status of the inquiry.
