New ortho referral
Order present • Imaging missing
Workflow Use Case
Referral Management
Manage referral intake, completeness, communication, status updates, and scheduling from one centralized referral queue.
Last updated:
One workflow for inbound and outbound referrals
Missing information chased automatically
Status and provider communication stay visible end to end
Operational picture
Closed-loop referral execution
Referral work moves from intake to completeness review, scheduling, status follow-up, and provider updates in one queue.
Signals
Referral fax
Provider message
Patient follow-up
Outbound consult
Specialist selected
Ready to schedule
Insurance checked • Patient contacted
Packet completeness check
Status follow-up cadence
Provider update messages
How it works
Four steps, start to finish
Here is the whole path a case takes, from the moment it shows up to the moment it is done.
01 / Inbox
The referral comes in
Referrals arrive by fax, portal, email, or upload and all land in one shared referral list.
The referral shows up right away instead of sitting in one inbox.
02 / Checklist
You see what is missing
Calvient checks for the order, the diagnosis, demographics, insurance, and whatever the specialty requires.
You know a referral is incomplete before you try to schedule it.
03 / Tasks
The gaps get chased down
Calvient messages the referring office or the patient for what is missing and moves the ready referrals toward scheduling.
The next step is always clear, and someone owns it.
04 / Status
You follow it to the finish
The status stays current from new to scheduled to seen, including the note that comes back from the specialist.
Patients and referring offices stop disappearing into a black hole.
What operators see
Product views that move the workflow forward
These are the working surfaces that keep the queue understandable, actionable, and measurable.
Inbox
Referral queue with completeness signals
Coordinators see referral type, patient context, missing artifacts, and the next route before they touch the case.
Cardiology referral
Needs echo report before scheduling
GI outbound referral
Packet ready to send
Neurology consult
Waiting on patient response
- Referral source and specialty
- Missing-doc flags up front
- Suggested next status
Tasks
Referral timeline and work ownership
The queue shows who owns the case, what is waiting, and which communication needs to happen next.
Request imaging records
Fax + call cadence active
Schedule new consult
Patient text sent
Consult note chase
Outside office overdue
- Provider outreach tasks
- Patient scheduling follow-up
- Consult-note return tracking
Reporting
Turnaround and leakage visibility
Leaders can see where referrals stall, which sources send incomplete packets, and where conversion drops.
Inbound referrals
Fastest turnaround this week
Outbound coordination
Most missing records follow-up
Consult note returns
Biggest leakage risk
- Days to first action
- Scheduled conversion rate
- Leakage and status aging
Workflow Views In Product
In Product
Referral queue view
Queue view with completeness tags, owner, and next status.
In Product
Referral timeline
Case history showing provider outreach, patient outreach, and closure state.
Referral ROI Calculator
What could referral management give back?
Choose inbound or outbound, set your volumes, and see the staff hours and labor cost Calvient could reclaim.
Sets the default monthly volumes for each workflow.
Loaded staff rate
$30.25/hr
U.S. average · medical admin staff wage
Choose your referral workflow
Most practices focus on one — pick inbound or outbound to see its estimate.
Inbound Referral Management
Receiving and working inbound referrals with less manual handling.
Expected
Annual hours reclaimed
—
Annual staff savings
—
Monthly hours
—
Monthly savings
—
Select a workflow above to build your estimate.
Special Agents
Special Agents for this workflow
These agents are useful because they handle the repetitive middle of the workflow while leaving sensitive or ambiguous decisions with staff.
Referral completeness checker
Compares each packet against your referral requirements before the case gets scheduled or advanced.
Trigger
New inbound or outbound referral packet
Actions
- Check required order and document set
- Flag what is missing
- Create targeted follow-up tasks
Handoff
Returns the case to coordinators only when exceptions need human judgment.
Referral status follow-up agent
Runs recurring status checks so coordinators are not manually rechecking the same cases all day.
Trigger
Cases that are waiting on scheduling, consult notes, or outside-provider action
Actions
- Send follow-up messages
- Log status changes
- Advance or re-queue based on reply
Handoff
Escalates only when the referral is aging out or blocked.
Provider update agent
Keeps referring offices informed at key milestones without manual status emails or calls for every case.
Trigger
Milestone changes such as scheduled, incomplete, or completed
Actions
- Send provider-facing updates
- Attach status reason
- Record the communication in the case history
Handoff
Routes high-friction provider communication to the coordinator managing the case.
Operational channels
The workflow moves across multiple channels without losing state
Referral management spans inbound packets, outbound coordination, patient follow-up, and outside-provider communication.
Fax
Text
Phone
Browser
Forms
EHR / integrations
Fax
Inbound referral packets, outside records, and consult-note returns
Text
Patient outreach for scheduling and missing intake steps
Phone
Provider offices, patient callbacks, and unresolved referral status checks
Browser
Portal status review or specialist coordination where no API exists
Forms
Referral request forms, uploads, and patient-submitted documents
EHR / integrations
Chart context, scheduling handoff, and referral filing
Teams that use this
Deployment usually spans more than one team
Most organizations split referral work across intake, access, and follow-up. This page is designed to keep all three looking at the same operating state.
Referral Coordinators
Front Office
Access Center
KPIs / outcomes
Measure the outcomes that matter
The right operating system should make these measures easier to see, easier to improve, and easier to explain to leadership.
KPI
Referral turnaround time
How long referrals take from receipt to meaningful progress or closure.
KPI
Days to first action
How quickly a new referral gets worked after it arrives.
KPI
Scheduled conversion rate
How many workable referrals reach the scheduled state.
KPI
Referral leakage
How many referrals stall, disappear, or fail to close the loop.
Related use cases
Explore adjacent workflows
Intake & Triage
Capture inbound work from fax, email, forms, and other channels, classify it, and route it to the right team and queue.
Prior Auth & Payer Ops
Handle benefits checks, prior auth submissions, payer portal submissions, status follow-up, and renewals.
Scheduling & Patient Readiness
Prepare patients before visits with reminders, paperwork, insurance updates, and appointment coordination.
Frequently Asked Questions
How does referral intake automation work for a high-volume specialty clinic? +
Referral intake automation captures every inbound referral — fax, portal, or direct message — into a tracked queue, validates completeness against required clinical and demographic fields, triggers outreach for anything missing, and routes each referral by specialty, urgency, or payer. At high volume the practical difference is that staff stop touching clean referrals entirely and only see the exceptions.
What information does Calvient check when verifying insurance for an inbound referral? +
Calvient checks eligibility, plan type, and whether the referring and receiving providers are in-network. It flags coverage gaps or plan mismatches before the patient is scheduled so the team has time to resolve issues rather than discovering them at the visit.
How does Calvient handle referrals that arrive with missing documentation? +
Calvient identifies what is missing, logs the gap, and routes the referral to the appropriate queue with a clear status. It can also trigger outreach to the referring office to collect what is needed without requiring staff to manually track each open item.
Can Calvient route referrals to different queues based on specialty or urgency? +
Yes. Routing rules can be defined by specialty, referral source, payer, urgency designation, or a combination of factors. Queue assignments update automatically as referral details are filled in.
How does the consult note tracking work after the patient is seen? +
Calvient monitors for the incoming consult note and flags referrals where the note has not arrived within the expected window. Staff see outstanding notes in a dedicated queue rather than relying on memory or manual follow-up.
Can Calvient track the status of a referral end to end? +
Yes. Calvient maintains a status record for each referral from initial intake through scheduling, records exchange, and consult note return. Leadership can see where referrals are stalling across the full workflow.