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Referring Physicians

Updated: 12/02/2020
Views: 3741

Referring physicians are generally third-party physicians who have referred patients to various providers within a practice. Maintaining a list of referring physicians is important for several reasons:

  • Many insurance companies require information about referring physicians for proper reimbursement.
  • Reports can be used to track the income generated from referrals.
  • Referring physician records include information you may need in order to contact them.

You always begin with finding the referring physician before adding, editing, deactivating/reactivating or deleting a referring physician.

Find Referring Physician

  • Click Settings > Other Lists > Find Referring Physicians. The Find Referring Physicians window opens.
    Tip_Icon.pngTip: When there are numerous referring physicians, use the Look For search bar to enter all or part of a keyword for the physician. Then, click Find Now

New Referring Physician

  1. Verify the referring physician is not in the system then click New
    on the bottom. The New Referring Physician window opens.
  2. Under the General tab, enter the information.
    Note: At minimum, enter the referring physician's Full Name, Individual NPI, Specialty, Address, and one phone number.
    1. Full Name: The referring physician's full name.
    2. Date of Birth: The referring physician's date of birth using the format "MM/DD/YYYY" (e.g., 05/25/1960).
    3. Individual NPI: The individual National Provider Identifier assigned to the referring physician.
    4. SSN: The referring physician's 9-digit Social Security Number.
    5. Specialty: Click Specialty to search and select the referring physician's main specialty from the list of taxonomy codes.
    6. Degree: The referring physician's degree (e.g., DO, MD, PhD).
    7. Address: The referring physician's office address must be a physical location (not a P.O. Box) and include a 9-digit zip code.
    8. Email: The referring physician's email address.
    9. HomeWorkMobile: Enter at least one phone number for the referring physician.
      • If applicable, enter the Pager and/or Fax number(s).
    10. Notes: Internal notes related to the referring physician.
  3. Click Save. The Confirmation pop-up appears then click Yes to confirm.
    • If necessary, click the Claim Settings tab to configure the referring physician's claim settings.  

Edit Referring Physician

  1. Find the referring physician then double click to open it. The Edit Referring Physician window opens.
  2. Make the desired changes under the General and/or Claim Settings tab.
  3. Click Save. The Confirmation pop-up appears then click Yes to confirm.

Deactivate/Reactivate Referring Physician

Deactivate a referring physician's record so that it no longer appears when looking up referring physicians in such tasks as Encounter Details. Then, restore availability by reactivating the record when necessary.

  1. Find the referring physician then double click to open it. The Edit Referring Physician window opens.
  2. Locate the "Active" option and deactivate or reactivate the referring physician.
    • To deactivate, click to clear the selection.
    • To reactivate, click to select.
  3. Click Save. The Confirmation pop-up appears then click Yes to confirm.

Delete Referring Physician

  1. Find the referring physician then click once to select it > Delete. The confirmation pop-up appears.
  2. Click Yes to confirm the deletion. The referring physician is deleted.

Note: Only referring physicians with no other records associated, such as an encounter, can be deleted. If a referring physician cannot be deleted, they can be deactivated.

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