How to Add or Edit a Referral

You can use the Referral pages to add or edit existing referral requests if a patient who is a ND Medicaid member needs to see another provider.

If you open a panel that has an action bar and add or edit information, before continuing, on the panel's action bar, click Save.

Optionally, you can:

• View or add notes. To view or add notes for this record, on the action bar, click Notes.

• View audit details. To retrieve audit information, close any open panels and, on the action bar, click Audit Log. To view the details for a particular record, click Audit.

• Reset your entries. To display the information on the page or panel as it appeared when you last clicked Save, click Reset.
• Cancel your entries. To close the page or panel without saving your changes, click Cancel.

To add or edit a referral request

1. On the Claims menu, click Referral.
2. To add or edit a referral, on the Referral search page, do one of the following:
   • To add, on the Referral action bar, click Add Referral.

   • To edit, search for the referral you want to edit.

3. On the Referral page, complete the fields.

   Note: If a monetary value (amount) includes cents, you must enter the decimal point.

   Tip: For efficient navigation, you can click the links at the top of the tabs to go directly to that panel.

4. On the Referral action bar, click Save.

5. If exceptions are found, to resolve the exceptions codes, do the following:

   1. In the Referral exceptions panel, click the exception Code that you wish to review.

   2. In the expanded panel, to display the first 50 characters for the resolution to this exception, click Resolution Text.

      If you need more information about the exception, click the Read complete resolution text to go to the Service Authorization Exception page of Rules Management, which displays detailed information for the exception. Click the Back button on your browser toolbar to navigate back to the Referral page.

   3. Considering the resolution text provided, resolve the exception.

   4. To redisplay the Referral exceptions panel with updated information, click Validate.

   5. Repeat Steps 6a-e until you have resolved the exception codes.

See Also

Referral Page

What Is Referral?

About Service Authorization Exception Pages

About Claims

Version as of 5/16/14.