REFERRAL TO OUTSIDE PRIMARY CARE PROVIDER

Effective Date: 
Fri, 08/11/2017
Revised: 
Tue, 09/26/2017
Policy: 

Student Health Services (SHS) clinical staff provides primary care for UCSC students. Some patients with UC SHIP require consultation or ongoing care from an outside primary care provider due to distance or complexity if appropriate care is not available at SHS.  This determination will be made by the Medical Director in consultation with other primary care providers or managers if needed and on a case by case basis.

UC SHIP and the insurance carrier will be contacted by the Insurance Supervisor regarding the PCP referral and the student's clinician will be kept informed.

The student will be assigned a SHC case manager to help coordinate services and communicate with the students and the insurance carrier as needed.  The UCSC SHS case manager can make arrangements with Anthem Blue Cross to assign a case manager from the insurance carrier if needed.

The UCSC Student Health Center will continue to care for the student until primary care has transitioned.

This policy does not include patients using reciprocity at other UC Student Health Centers.

It is preferred that these students get all or most of their care off campus, i.e optometry, labs and pharmacy, however, this can be determined by the department.  CAPS will make their own determination and refer as necessary.

 

 

 

Procedure: 

A referral form is generated by the Medical Director or designee to communicate clinical history, reason for referral, to authorize referral for insurance purposes, and to document a reminder to reauthorize the referral each year if the patient is still a UCSC student with UC SHIP. 

A case manager will be assigned.

This information will be shared in the EMR under Scheduler Comments, Clinical Comments and Admin Alert.  A broadcast IM will be sent to the Alert Group, the Laboratory for entering into Harvest and to Pharmacy to enter into Propharm.

The EMR documentation process is as follows:

1. Scheduler Comments (OpenRegistration > Registration > Scheduler Comments)

2. Clinical Comments (OpenChart > Clinical Comments > All Divisions)

3. Admin Alert (OpenRegistration > Admin Alert)

A Broadcast Instant Message will be sent via the EMR to the “Alert Group” comprised of management and IT staff. Laboratory management or IT will add an alert in the “Harvest” lab interface program. Pharmacy management or IT will add the alert in the “Propharm” prescription interface program.

Harvest

Open the patient
Click “…” under alerts
Add in text from PNC IM
Save patient

Propharm

Open the patient
Click on the note icon (paper with a thumbtack)
Select New
Title with the IM title from PNC
Add in body of note
Set Priority = High
Save

This system of alert notification will help assure all SHS staff have immediate access to any student with outside PCP alerts relevant to staff.  In the event a student with this alert system in place presents or contacts the SHS, all staff should immediately alert their supervisor for further instructions.