Overview

Arcadia Referrals is a healthcare referral management solution designed to streamline and automate the referral process, allowing healthcare teams to focus on high-value tasks. By integrating robust data from various sources, it facilitates efficient routing of patient volume to in-network providers, enhancing care coordination and reducing administrative burdens. The system is customizable, supporting both centralized and decentralized referral management approaches to align with organizational workflows.

Features and Capabilities

• Flexible Configuration:
  • Supports both centralized and decentralized referral management approaches.
  • Customizable to align with specific organizational workflows.
• Comprehensive Data Access:
  • Integrates relevant specialist and insurance information from external sources beyond the Electronic Health Record (EHR) system.
  • Provides a complete view of patient and provider information to facilitate informed decision-making.
• Web-Based Referral Entry and Queue Management:
  • Allows for easy submission and management of referral requests through a web-based interface.
  • Utilizes "nudges" to direct volume to preferred providers, considering factors like reduced travel time and lower costs.
• Automated Approval Process:
  • Employs a rules engine to automatically approve referrals to in-network or approved specialists based on insurance eligibility.
  • Standardizes processes to address out-of-network referrals, decreasing turnaround time.
• Enhanced Care Coordination:
  • Suggests in-network specialists best suited for the patient by considering various patient and provider factors.
  • Supports decisions in patient volume routing based on cost, efficiency, and quality metrics.
• Administrative Efficiency:
  • Reduces time spent on administrative tasks by referral teams, allowing them to focus on more pressing responsibilities.
  • Streamlines the referral process, leading to improved operational efficiency.