Kalix's Referrals contain important client information including the referral reason, the referral source and diagnosis. This information is used by the billing feature to produce CMS 1500 forms (for more information click here) and superbills. Referrals can also be used to keep track of the number of appointments a client has attended via the referral tracking functionality and link the referral source to the client.
Note: If you create superbills or CMS-1500 forms, even if the client does not have a referring provider, we still recommend that you create a referral for them. A referral does not require a a referral source. Referral as very useful for auto-adding the diagnosis reasons (ICD-10 diagnosis) to superbills and CMS -1500 forms.
Referrals are located under the Clients tab on menu bar, subtab Referrals.
Above is the referrals summary page, you will see this screen when you first click on the Referrals subsection. The Referrals summary page lists all of your saved referrals. You can filter, search for, sort and order referrals on this screen. We will discuss the referral summary page later.
Creating a New Referral
There are three different navigation pathways to create a new referral.
To create a new referral, on the Referrals page, click on the Quick Link 'New Referral', located on the top right of the screen (shown above).
On the client's Cover Page, under the referrals subsection, click on the New Referral link as shown below.
Alternatively, on the top Kalix menu bar, click on Clients on the top header followed by New and Referral.
New Referral Page
All pathways lead to the New Referral page (shown below). We will now go over the different parts of this page.
The first field is Status. Assigning a status against referrals can assist with the management and organization of client flow. There are four referral status:
- Waiting List- Assign this status to a referral if you are yet to contact the applicable client to arrange an appointment. Referrals on the waiting list are managed under the subsection of Waiting List (Client tab -> subsection Waiting List). When you book an appointment associated with a particular referral, the referral status will automatically change to active.
- Active- Assign this status if you are providing the applicable client with ongoing care under the referral.
- On Hold- The referral is still valid (i.e. has appointments/hours remaining and not expired), but the client is not receiving ongoing appointments under it e.g. because they are on holiday.
- Closed- The referral is no longer valid or client has ceased attending appointments.
To select a referral status, just click on the Status field and the drop down box should appear, click on your selection.
There are two date fields, date received and date on referral.
Date Received- The actual date you received the referral, this is usually a different date from what appears on the referral.
Date on Referral- The date written on the referring practitioner's referral form. This is the date automatically entered onto Superbills generated in Kalix.
To select a date, click on the date field, a calendar will appear (shown above). Select the applicable date by clicking on the date square. Move backwards or forwards between months using the arrows on the top bar of the calendar. Alternatively type the required date into the date field.
Go to the section titled Client. To add your client, start writing their name in the 'Link Client' field. A list should be generated containing clients with similar names, just click on the applicable name to select it.
If your client is yet to be saved into Kalix, click on the link 'New Client' (shown below). You will be redirected to the New Client screen, enter you clients details and save. Once you have created and saved the client, go back to the New Referral screen.
Go to the section titled Referral Source. To add your referral source e.g. the referring provider, start writing their name in the 'Link Contact' field. A list should be generated containing contacts with similar names, just click on the applicable name to select it. For more information about contacts, click here.
If your referral source is yet to be saved into Kalix as a contact, click on the link 'New Contact' (shown above). You will be redirected to the New Contact screen, enter your referral source's details and save.
The referral source will be entered into Superbills and CMS 1500 forms generated in Kalix as the Referring Provider (item number 17 on PDF version of CMS 1500 form).
Once you linked the referral source, if billing using the CMS 1500 form, select the qualifier for the Referring Provider (as shown below).
Kalix allows you to place an appointment cap and expiry date against referrals. Click here for details.
When creating bills (superbills and CMS 1500) in Kalix, data entered into this section will automatically inputted into your bill.
Kalix offers you the ability to enter up to four ICD-10 or ICD-9 diagnoses. All of the ICD-9 and ICD-10 diagnosis codes are pre-loaded into Kalix. Tick the select box as shown below to choose to include ICD-10 Diagnosis (leave the select box unticked to use ICD-9).
Search for the correct diagnosis using keywords or the diagnosis code. After entering one diagnosis, another diagnosis box will appear.
First symptom: enter the date of the first onset of the present illness, injury, or pregnancy. For pregnancy, use the date of the last menstrual period (LMP) as the first date. This field corresponds to item number 14 on the CMS 1500 form.
Additional Referral Details: free text box to enter details, for your information only.
Condition is related to-Employment, Auto Accident, Other Accident: select the relevant tick boxes if the client’s illness or injury is related to employment, auto accident, or other accident.
“Employment (current or previous)” indicates that the condition is related to the client’s job or workplace.
“Auto accident” indicates that the condition is the result of a vehicle incident.
“Other accident” indicates that the condition is the result of any other type of accident.
These fields correspond to item number 10a–10c on the CMS 1500 form. When creating a CMS 1500 form in Kalix, if these fields are not selected Kalix, will automatically enter "no" in these fields for you.
Dates unable to work in current occupation:
If the client is employed and is unable to work in their current occupation, enter the date range they are unable to work. An entry in this field may indicate employment-related insurance coverage.These fields correspond to item number 16 on CMS 1500 form.
Prior Authorization Number: enter the payer assigned number authorizing your service/s; can include the prior authorization number or referral number. This number is assigned by the payer for the current service. Do not enter hyphens or spaces within the number.
Make sure you click the Save button at the bottom of the page to save the referral.
Linking a Referral to an Appointment
By linking referrals to appointments, you can keep track of the number of appointments a client has attended via the referral tracking functionality. Additionally, when creating a bill (superbill or CMS 1500 form) for a specific appointment, Kalix will also auto add the appointment linked referral information to the bill.
A referral can be linked to an appointment on the New/Edit Appointment screen and the Appointment Details page. If there is a current active referral for a specific client, Kalix will automatically link this referral to the client's appointment as you first create it (via the New Appointment) click here for details.
If there is no referral associated with an appointment, you can link one up at any time via the Appointment Details page.
Linking a Referral to a Bill
When a bill is created for a specific appointment, Kalix will automatically add the information from the appointment linked referral to the bill.
Referral Summary Page
The referrals summary page is shown at the start of this document, this page lists all of your saved referrals. You can search for, sort and order referrals on this screen.
Search- You can search for referrals using keywords in the Search field.
Filter-To view referrals saved between a specified period of time, click on the Filter field as shown below and select the period you would like to see.
Date range- You are able to view referrals made between a specified date range in the next two fields. Select the starting date in the second field and the end date in the third field.
Status- In the last field you can choose to view referrals that are assigned a particular status (Waiting List, Active, On Hold, Close).
Sort- The table can also be sorted by each column; date, client ID, name, date of birth, referral reason, referral source and status.