NPHIES Referrals

06/06/22 Referred patients billing and charges approval with NPHIES

Escrito por Rubén Mosqueda Herrera
Actualizado hace más de una semana

We have now enhanced our patient care flow to allow certain type of patients to be admitted or discharged by your hospital in order to complete their care process, such as services and procedures that must be completed between two or more clinical facilities. This enhancement will allow you to both receive referred patients and to generate a reference NPHIES so they can complete their procedures at another hospital, if required.

Here below you will be able to see how to perform both scenarios:

a) Patients referred from other facility

When admitting a patient that was referred by another facility, in Patient Registration window, please select the Referred by another facility checkbox and Save.

After the required services were performed, go to Pending Order Authorization for NPHIES approval. The description bar (top) will display if your patient was referred from another facility.

Here you must enter the Reference ID information, see more here

After NPHIES approval, go to Multibilling window to complete the charges collection process. On this window, you will be able to see the Referred information:

This information will also be visible on other windows where encounter information is being displayed, such as Electronic Patient Record:

Referred information will also be displayed for patients that were referred to another hospital to complete their processes. Instead of Referred from other facility it will display Referred to other facility:

b) Patients referred to another facility

To referr patients to another facility, complete your usual procedures and in Pending Order Authorization select Professional in Claim Type, then mark the Referred to other facility check box and click Nphies Pre-auth button to send this information :

This will allow users to obtain Reference ID in response for their completion.

We hope this improves your Cirrus experience. Remember to share this information and ask for help if you need it.

Date: June 6, 2022

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