In Pending Order Authorization window you can now enter ID numbers for both Online and Offline references, allowing you to send NPHIES Pre-Authorization orders for patients who were referred by a different hospital and required services from your hospital.
Referred patients are those patients who can arrive to complete their procedures from many sources: specialist medical consultants, general practitioners,practice nurses, community health workers, dentists, and they may be referred to your hospital to complete any missing procedure. This can also happen when a current patient from your hospital needs to be referred to another clinic to finish their required procedures. Here is where a referral letter may be required during their admission and an ID must be entered for NPHIES validation.
Here we will show you how to add this information on NPHIES requests.
Go to Pending Order Authorization window and perform the current NPHIES response actions (see link).
Here you will see some new fields below Claim Type:
A. Select claim type. Professional claim is for referrals validation and other professional charges.
B. Mark Is Online Eligilibity box if Reference ID is online. If not, leave it blank, and proceed.
C. Now enter Reference ID number.
D. Reference Date. For offline references only, enter date and hour of reference.
After selecting your charges from the list below, click Send Nphies Pre-Auth button. You will see a confirmation message:
We hope this improves your Cirrus experience. Remember to share this information and ask for help if you need it.
Date: May 16, 2022