REFERRAL TRACKING POLICY

Effective Date: 
Tue, 08/09/2011
Reviewed: 
Fri, 05/15/2015
Revised: 
Wed, 06/10/2015
Policy: 

The SHC provides referrals for care that cannot be provided at UCSC Student Health Services, or is appropriate to continue elsewhere.

In the case of potentially serious clinical problems that are being referred off campus, the referring clinician will designate the referral to be tracked.  Examples include referrals for breast masses, rectal bleeding, and skin lesions suspicious for cancer.  Insurance Office personnel will follow up on these referrals designated for tracking and communicate to the referring SHC clinician in a timely manner if the consultation note is not received in 30 days or by the time requested. 

Procedure: 

REFERRAL TRACKING PROCEDURE

1.      Clinician initiates outside referral in the electronic medical record and indicates the request for tracking assistance by clicking TRACK as the Urgency preference.  If the clinician forgets to designate tracking prior to signing the referral, they will compose an instant message to the Insurance Office staff requesting tracking of that individual referral.  Clinician confirms accuracy and preference for contact information with student at time of referral.  Clinician gives paper copy to patient and refers student to the insurance office for an explanation of insurance coverage.

2.     Insurance Office personnel perform initial review four weeks after the TRACK REFERRAL is requested. In the PNC facility view, the Insurance staff may review referrals designated by clinicians for tracking 4 weeks after the referral has been made.  If the initialed outside consultation report has been scanned into the medical records document section then no further action by Insurance office personnel is required.  If the report has been scanned but does not have the ordering clinicians initial on the report, an instant message will be sent to the ordering clinician drawing their attention to the report and no further action is required by Insurance personnel.

3.      If a report cannot be found by the Insurance office personnel in the EMR on initial review, the insurance office personnel will initiate phone call to the student confirming that consultation/test has been completed.  Insurance office personnel will phone or fax message to consultant requesting written report be faxed to SHC and will continue weekly contact with outside consultant or facility until report received. If a written response has not been received within two weeks of the appointment date and three attempts at contacting consultant office have failed to produce report, the referring SHC provider is notified of no response from consultant.

4.      Students who have not scheduled appointment or tests will be offered assistance by Insurance office if the student desires.  Insurance office personnel will document conversation with student and IM the clinician if student has not scheduled or completed recommended referral services.  The Clinician is responsible for documenting disposition of those declining referral services in the medical chart. After careful review, the clinician will indicate NO further tracking indicated in the medical chart when appropriate and instant message back to Insurance Office who will discontinue further attempts at tracking the referral.