Problem Statement

Referrals must be received, validated, and acted on before a specialist visit, because many payers require an authorized referral on file or the visit denies. Sometimes a valid referral is already on file but simply isn't linked to the visit, and that gap alone produces a denial even though the referral exists. Finding these unlinked encounters and linking them by hand is repetitive work, and Revenue Management has identified large denial volumes traced to exactly this missed step.

Automation Solution

This automation identifies Epic encounters with an existing but unlinked referral, links the referral at the appointment desk, and prevents the downstream referral denial.