PlayMaker Spark has the ability to work with a large number of Electronic Medical Records providers (EMR) to integrate medical records directly into the PlayMaker environment. These integrated PlayMaker environments are referred to as Enterprise clients. For environments that do not have an integration (referred to as Pro clients), referrals can be created manually. This article outlines the process for manually creating a referral.
Note: If your organization has an integration, referrals should never be created manually in PlayMaker. The EMR provider is the source of all referrals/orders. If you are unsure if your organization has an integration or not, please check with your manager or system administrator before attempting to manually create a referral.
Manually Creating a Referral
Referrals can be created only on the web (not in the mobile application) by following these steps:
• Log into the PlayMaker Spark web environment.
• Click on the Referrals link to go to the Referrals page (shown below).
• Click the New Referral button at the top of the page.
• The Referral Details page appears. There are only two required sections that need data for a pending referral to be saved (Primary Physician and Business Line), but we suggest entering as much detail as possible to improve searching and reporting.
• Once satisfied with the data that has been entered for the referral, click the Save button at the top or the bottom of the Referral Details page.
Defining Referral Fields
The Referral Details screen is broken into 7 sections by default. The below listing breaks down the different sections of a referral and explains each of the fields.
Section 1: Referral
The first section details basic information about the referral in two columns. The fields in this section are as follows:
- Primary Physician - This is the physician whose NPI is on the referral. This is a required field. Clicking on this field (or the magnifying glass icon to the right) will open a search to attach an existing contact. If the contact does not exist in your PlayMaker environment, the contact will need to be created before creating the referral.
- Referring Facility - This is the facility (or account) that is listed on the referral. Clicking on this field (or the magnifying glass icon to the right) will open a search to attach an existing account. If the account does not exist in your PlayMaker environment, the account will need to be created before creating the referral.
- Referring Person - This is the contact who referred the patient. This contact may be a Medical Director or other staff member and may not be on the claim itself. Clicking on this field (or the magnifying glass icon to the right) will open a search to attach an existing contact. If the contact does not exist in your PlayMaker environment, the contact will need to be created before creating the referral.
- Patient Name - The patient on the referral. This is a text field where users can enter the name of the patient.
- Branch - The Branch field is a dropdown menu that is used to set which sales territory the referral is associated to.
- Date Entered - This is the date the referral is being entered into PlayMaker and is not able to be edited.
- Referral Status - This is a dropdown menu that indicates the status of the referral (Pending, Admit, or Non-Admit). This field defaults to Pending, and can be updated after a Start of Care date or a Non-Admit date.
- Insurance Type - This field is a dropdown menu that allows users to set which insurance type is being used on the claim.
- Business Line - This dropdown should list options for which business line the referral is for (Home Health, Hospice, Palliative Care, etc.). This field may contain just one value (All Business Lines) as not all agencies decide to add additional options. This is a required field.
Section 2: Referral Owners
This section of the referral only contains one field, which determines who the referral is assigned to. By default, the user creating the referral will be assigned the record.
To change owners, click the X next to the current owner's name. Then click the Add Referral Owner to be able to select a new owner. In order to be assigned as an owner, the user must have an active user account in PlayMaker. Multiple owners can be assigned, should two reps share the credit on a particular referral.
Section 3: Orders
The Orders section has one field available (Order Status). This field is designed to alert a sales rep that they need to collect a signature for an order. Alternately, the rep can update the field to note that the order has been signed.
Section 4: Notes
The Notes section contains a text field for entering any general notes about the referral.
Section 5: Admit
This section contains the following fields that should be populated when a referral is entered as an Admit or becomes an Admit:
- SOC Date - The Start of Care date for the admitted patient. Clicking in this field will bring up a calendar so that a date can be chosen. To type in a date, use a two-digit month, two-digit day, and four-digit year (ie. 07/22/2018). This field is required to save a referral as an Admit.
- Discharge Date - This date needs to be entered to show that a patient has been discharged. If this field is not populated, it will count against your census (which a referral view can display). Clicking in this field will bring up a calendar so that a date can be chosen. To type in a date, use a two-digit month, two-digit day, and four-digit year (ie. 07/22/2018).
- LOS - The Length of Stay will calculate automatically once a SOC Date has been populated. This field updates once per day. It will stop calculating once a Discharge Date has been entered, at which point the LOS value will remain constant for the days of care the patient received before discharge. This field cannot be edited.
- Verified - This field is a simple dropdown menu between Yes and No, allowing a way to manually mark whether or not the patient's eligibility has been verified.
- Discharge Reason - This field is a text box that allows for details to be entered regarding why the patient was discharged.
Section 6: Non-Admit
This section contains the following fields that should be populated when a referral is entered as a Non-Admit or becomes a Non-Admit:
- Non-Admit Date - This field is for the date for the referral became a non-admit. Clicking in this field will bring up a calendar so that a date can be chosen. To type in a date, use a two-digit month, two-digit day, and four-digit year (ie. 07/22/2018). This field is required to save a referral as a Non-Admit.
- Non-Admit Reason Details - This field is a text box allowing for any specific notes about why the referral became a non-admit.
- Non-Admit Reason - This dropdown menu has a variety of reasons to choose from to indicate why the referral became a non-admit.
Section 7: Record Details
This section displays information about the PlayMaker referral record. The below fields cannot be edited:
- PlayMaker ID - This is the referral's record number. This number is generated once a referral has been saved, but will read "NEW" while entering a new referral.
- Last Modified by - This field is populated by the PlayMaker application, indicating who last made a modification to the record.
- Last Modified on - This field is populated by the PlayMaker application, indicating when the last modification was made to the record.
Notes on Creating Referrals
PlayMaker Spark offers administrators the ability to add custom fields to various records, including referrals. It should be noted that some of the fields above may have a different name than presented here, as some of the names of the fields may have been changed by an Administrator. It's also possible that entirely new fields have been created that are not listed here, as this article only covers the default fields on the Referral Details page. Lastly, it may be important to note that some fields may have been marked as required fields by your system administrator that are not required by default.