REFERRAL Codes and Sources

OVERVIEW: The Referral Codes Table will allow the user

to enter referring physicians and referring

sources for the patients. These codes will be

used for EDI billing and hardcopy claims, when

necessary, to identify the referring provider.

PROCEDURE: Select Option 5 from the Tables/Dictionary Menu.

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After you select Option 5, the screen on the next page will display.

Press the <Enter> key to automatically generate the referral code or

manually enter up to 11 characters alpha/numeric or combination of both)

If you do not know the referral code, type a few letters of the referral

Name. The list of existing codes will display as you are typing.

You may also click the search icon or press the search key (<Tab> or F2)

A search screen will display existing referrals.

Highlight your selection and click or press <ENTER KEY>.

If a new code entered is not on file, the system will prompt.

If you do not want to add this code, type or click N.

The cursor will return to the ENTER CODE prompt.

If you do want to add this code, type a Y.

The Referral Source Definition module below will be displayed.

For a complete listing of Referral database click on the “Reports”

icon and follow the prompts. Other referring code reports are

located on the dictionary reports menu.

EXAMPLE SCREEN:

DEFINITION OF FIELDS:

1. Name: Type the referring physician's name (last name

first, then comma and first name followed by any title

abbreviations). Press <ENTER KEY>. Example: WELBY, MARCUS MD

2. Address: Type in the referring physician's street address

and <ENTER KEY>. DO NOT USE lower case letters as "5th". The

street address should appear as follows: 13325 5TH AVE.

3. RF_ADD2: If the address contains a suite number, enter the

number here and <ENTER KEY>. Example: Suite 102. DO NOT USE any

punctuation or a "#" to indicate the room number.

4. City: Enter the City and press <ENTER KEY>.

5. State/Zip: Enter a two-digit post office abbreviation for

the state. Enter the zip code (this field will hold up to

13 numbers) and press <ENTER KEY>.

6. Phone: Type the referring physician's telephone number.

Enter the area code first, the phone number second, an extension

third, and then press <ENTER KEY>. If there is no extension, press

<ENTER KEY> after entering the phone number. This field is used

by TPA.

7. RF_CELL_NO: Enter the pager number of the referring source

and press <ENTER KEY>. If there is no extension, press <ENTER KEY>

to bypass that field. This field is used by TPA.

8. RF-FAXNO: Enter the fax or private number of the referral

and press <ENTER KEY>.

9. BCBS#: Enter the Blue Cross/Blue Shield legacy ID number of the

referring source and press <ENTER KEY>. This is used for out of

network PPO providers.

10. UPIN#: Enter the Medicare UPIN number here and press

<ENTER KEY>.

11. Medicare#: Enter the Medicare ID number of the referring

source and press <ENTER KEY>.

12. Medicaid#: Enter the Medicaid Provider Code (this consists of

7 digits for actual Provider Code plus 2 digits that identify

the Provider Type) of the referring source. Do not use dashes,

slashes or spaces.

13. TaxID#: Enter the Tax-ID# number of the referring

source and press <ENTER KEY>. Commercial hardcopy uses this.

14. RF LIC NO: Enter the referring source's license number and

press <ENTER KEY>. This is a 6 digit number preceded by the initials

of the first and last name. Do not use dashes, slashes, or spaces.

Example: SH123456

15. TAXONOMY 1: Type of referral to be used for medical reporting

purposes.

16. TAXONOMY 2: Type of referral to be used for insurance reporting

purposes.

17. EMR Name: Enter the version of the Physician name to display

in the EMR screens and charts.

18. SPECIALTY: If the referring physician has a specialty,

you may enter that specialty here. Maximum of 25 characters

including spaces.

19-24. These fields are for EMR use. Fill in as appropriate.

25-31. Populate at least field 25 with the Physicians individual

NPI. All existing NPPES NPIs can be searched with the search icon.

Example NPPE NPI search screen:

REFFERAL SEARCH:

At the ENTER CODE prompt, type the first letter or letters of

the referring source and press <Tab>. The system will open a

window in the middle of your screen displaying all the sources

in the system that start with those letters.

EXAMPLE SCREEN:

In this example we have entered JAC. After you click search,

a screen similar to the one below will be displayed.

EXAMPLE SCREEN:

<Up>=Last Name,<Down>=Next Name,<Right>=Next Page,<Left>=Last Page

<Up>/<Down> <Right>/<Left> refer to Arrow keys.

The screen displays referring sources in the system starting

with the letters you entered. The name of each referring

source is preceded by the code which identifies it. To select

a source, at the flashing cursor type the number to the far

left of the source and press <ENTER KEY>, or highlight the line

using the <Up>/<Down> arrow keys and then press <ENTER KEY>. In

either case, the system will display the information on the

source you selected to your screen.

To exit a search screen, type 0 (zero) and press <ENTER KEY>.

ACTION LINE FUNCTIONS:

ACTION-> (Enter # to correct,(P)rt,(F)wd,(B)ck,(K)py,(D)el,(V)fy,Esc=END

Enter # to correct: Enter the number of the field you need to

correct and press <ENTER KEY>. The cursor will move to the first

character on that line (information on that line will not be

erased). You may retype the entire line, or position the cursor

on the character that needs correcting. Press <Home> to go

back to the Action Line.

(P)rint: Type P and press <ENTER KEY> to print a hard copy of

the information. The system will open a window in the

middle of your screen listing output devices. Please see

the example below.

Type in the number of your selection at the flashing cursor

and press <ENTER KEY>. You may also use the <Up>/<Down> arrow

keys to highlight your selection and then press <ENTER KEY>.

(F)orward: To go forward one code, type F and press <ENTER KEY>.

(B)ack: To go back one code, type and press <ENTER KEY>.

(K)opy: To make a copy of this information (be sure you O (zero)

and <ENTER KEY> to save it before you copy) and assign it a different

referral code, type K and press <ENTER KEY>. The cursor will move to

the ENTER CODE prompt. Enter the in-house referral code you wish

this information copied to and press <ENTER KEY>.

(D)elete: If you want to delete this referral code from the

system, enter a D and press <ENTER KEY>. Do not delete a referral

code that has been used.

(V)erify: Type V to verify the original entry date and/or

the date this screen was last updated.

Esc=END: To save your entry and exit to the ENTER CODE prompt

type 0 (zero) and press <ENTER KEY>. You may enter more codes

or type O (zero) and press <ENTER KEY> again to go to the

Dictionary Menu.

ARROW KEY FUNCTIONS

<Up>/<Down> Directional Arrow Keys: When at the Action

Line, you may press the <Up> arrow key to have the cursor

move to the last field. From there you may <Up> arrow all

the way to Field 1. From Field 1, you may <Down> arrow to

the last field. Field entries will not be erased. You may

edit any field. To return to the Action Line from any field,

press the <Home> key.

<Right>/<Left> Directional Arrow Keys: When making corrections,

use the <Right>/<Left> arrow keys to locate the area for correct-

ing without erasing any of the other information. To return to

the Action Line, press the <Home> key.

Note: Office Medicine can pre-load all NPIs for a given state or zipcode

by request.