Welcome to the Submitting and Searching Referrals training video!

In this module, we will review how to submit and search for referrals.

Please note that only select plans may have these features available. Also, a referral is NOT a substitute for an authorization and therefore cannot be used for claims payment. Referrals submitted via the portal simply offer providers a way to print a referral form to hand to their members.

To submit a new referral, users can navigate to the Care Management area in the main navigation.

However, we recommend navigating to My Patients and searching for a member. The reason this is the preferred method is that users can easily submit a new referral by selecting the option from the Select Action dropdown menu. In this case, the member information is pre-populated on the form.

If needed, the user can search for another member using the Choose Another Member tool.

If the user is affiliated with a single provider ID, the requesting provider information will also prepopulate in the form. If the user is associated with multiple provider IDs, they will have to search and select a provider using the Choose a Provider tool.

Note that when a user starts typing a diagnosis code, the system dynamically displays a list of codes to choose from.

Prior to submission, if any of the required fields are not complete, the system prompts the user to enter that information. When the user creates the referral, the system provides an opportunity to review it and make any changes prior to submission.

Please note that a referral isn’t submitted until the user selects the Submit Referral button.

The system then displays a confirmation message that includes a referral number. The user can also download and print a copy of the confirmation screen.

Search and View Referrals

To search and view referrals, users can navigate from the Care Management menu.

On the Care Management home page, users should select the Referrals tab. They are able to search for referrals by member ID, member name and DOB, or requesting provider ID or treating provider ID.

Users can select the duration they’d like to search or enter a custom date range for up to a year at a time.

The system will return a list of referrals based on the search criteria.

If the system returns a long list of referrals, users can sort using the column headers or filter using the Filter Results option. User may also download their results into a report in the file format of their choosing.

From the results, the user can select and view the details for individual referrals from the Select Action drop down.

From the Referral Details page, users can download and print the referral in PDF format.