Healthcare organizations often face significant referral leakage, with 55%-65% of patient referrals directed to out-of-network providers, resulting in revenue loss. Manual processes like faxes and emails further reduce efficiency, as only 54% of faxed referrals lead to scheduled appointments.
Our AI-powered Healthcare Referral Management, built on ServiceNow, automates referral processes, reduces leakage, enhances provider communication, and ensures clarity and completeness in referral information. The result: streamlined operations, better coordination, and improved patient care.
- Specialized referral workflow automation built on ServiceNow capabilities to complete the following:
- A preliminary review of inbound referrals to determine if they are administratively complete.
- Determine if the inbound referral is associated with an existing patient record in the system, or if a new patient record needs to be created.
- Real-time visibility for referring coordinators into referral status.
- Integration with ServiceNow Document Intelligence to extract referral information from inbound referral forms.
- Integration with ServiceNow’s Now Assist to analyze referral completeness against applicable Referral Protocol Knowledge Articles and determine if referral requirements have been met or not based on the referral type.
- A Referral Coordinator Dasboard to capture the following metrics:
- Total Referrals by Medical Specialty
- Incomplete Referrals Queue
- Average Processing Time from “New” to “Approved”
- Total Referrals Approved
- Open/Active Referrals
- Total Referrals Submitted for New Patients
Resubmitted for Zurich recertification
Plugins Required:
· Now Assist in Document Intelligence (sn_docintel_gen_ai), Min Version 5.0.7
· Document Intelligence Admin (sn_docintel_admin), Min Version 4.0.3
· Now Assist for Customer Service Management (CSM) (sn_csm_gen_ai), Min Version 11.1.0
· Healthcare and Life Sciences Management Core (sn_hcls), Min Version 10.1.0
· Customer Service (com.sn_customerservice), Min Version 28.0.26
· CSM and FSM Configurable Workspace Foundation (sn_cwf_wrkspc) Min Version 25.1.5
· Now Assist Skill Kit (sn_skill_builder) Min Version 7.0.13