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    03 — Value stream · VS-480

    Referral-to-Appointment

    Turn a referral or a patient's own request into a booked visit the patient is ready for: the right clinician and slot, a matched patient record, verified coverage, any payer authorization in place and the patient told what it will cost. Delivering the visit itself starts Admit-to-Discharge or an outpatient encounter.

    • Referral-to-Visit
    • Access-to-Visit
    • Patient Access Flow
    • Request-to-Appointment
    // FIG. 03 · Stage flow
    1Receive Request2Register Patient3Schedule4Verify Coverage5Authorize6Estimate & Clear
    1. 01

      Receive Request

      VS-480.10

      Receive the referral or request with the reason and the clinical information that came with it.

    2. 02

      Register Patient

      VS-480.20

      Find or create the patient's record, then complete pre-registration with demographics and insurance.

    3. 03

      Schedule

      VS-480.50

      Book the slot with the right clinician and resources and send reminders and instructions.

    4. 04

      Verify Coverage

      VS-480.30

      Confirm the patient's coverage and benefits for the service requested.

    5. 05

      Authorize

      VS-480.40

      Obtain any prior authorization the payer requires before the service.

    6. 06

      Estimate & Clear

      VS-480.60

      Give the patient an estimate of what they will owe, help with financial assistance where needed and clear the account financially.