How to Automate Incoming Referrals Into ModMed

Like every healthcare organization in the U.S., referrals are a pain point for specialty groups. Every day, staff have to manually review a stack of documents, rekey and verify data, match the information to the right patient, and route the referrals to the right place. For those using ModMed, only fax referrals land near the fax queue while the others are usually routed to a shared space. They’re left untouched, patients are never contacted, and appointments are never booked. All of these gaps lead to avoidable referral leakage for health systems already operating on slim margins—to the tune of  $6.2 million a year across the industry.

Key Takeaways

• ModMed fax referrals land near the EMA fax queue, but the rest are routed to a shared space where they often sit—leading to a significant amount of revenue loss.
  
• With the Documo-ModMed Integration, most of the referral management process can be automated so staff can focus on high value, patient-facing tasks.
  

What are the Challenges with Referral Management?

Specialty groups are inundated with referral piles on a daily basis. Staff usually spend unnecessary time pulling referrals from the queue and then rekeying the data into charts. They also have to match the referral with the right patient.

Referrals come in through fax, portal downloads, scans, paper and occasionally, by secure direct message. For groups on ModMed, fax referrals land near the EMA fax queue, but the rest are routed to a shared inbox or a folder on a shared drive where they often sit untouched. Appointments are never booked and care is delayed. This is a common issue throughout the industry, with only 29% of organizations reporting fully automatic workflows. For multi-site locations that have individual fax numbers and workflows, the situation is more challenging since there’s no single queue and no way of knowing which location the leakage is coming from.

When referrals don’t result in appointments, patients may not receive the care they need—leading to higher utilization, poorer outcomes, and lower reimbursement under value-based care arrangements. And when referring providers don’t hear back from the practice they referred to, they send their next referral to another provider. For specialty groups on ModMed, referrals aren’t only a fax issue, but also a problem with intake.

ModMed’s Referral Workflow

Referral workflows are manual, time-consuming, and require multiple touches to review, rekey data, verify, route documents to the right place, and ultimately book the appointment. For ModMed users, here’s what a typical manual referral workflow looks like: 

1. Open the referral and review each page. 

2. Identify the patient name, date of birth, and insurance information. 

3. Identify the referring provider and the reason for the referral.

4. Determine which department, provider, or location should receive the referral.

5. Rename and save the referral. 

6. Re-key the data into the practice management system or EMA.

7. Contact the patient to schedule an appointment. 

8. If information is missing, follow up with the referring provider.

Task	Fully Automatable	Partially Automatable	Needs Human Intervention
Review the referral.	X
Identify the patient demographics.	X
Identify the referring provider and the reason for the referral.	X
Determine where the referral should be routed to.	X
Rename and save the referral.	X
Enter the patient and referral data into the practice management system or EMA.	X
Review incomplete fields, low-quality scans, ambiguous values.		X	X
Handle clinical triage decisions.			X
Schedule the appointment.		X	X
Follow up with the referring provider if information is missing.			X

Modmed Referral Management: What Can Be Automated and What Can’t

Most referrals still need to be touched by a human. In fact, 52% of faxes to health systems require staff intervention. These manual referral workflows are time consuming and can take as much as five to eight minutes before an appointment is even booked. For a practice that receives 500 referrals a month, that amounts to 2,500 to 4,000 minutes of unnecessary staff time.

How Documo Works With the ModMed EMA Fax Intake

With Documo, specialty groups can automate incoming referrals into ModMed— reducing administrative burden, delivering timely patient care, and improving operational efficiency. Documo integrates cloud fax and intelligent document processing (IDP) directly with ModMed so staff can accurately route and process referrals without toggling between systems. 

Here’s how it works: 

Receive: referrals arrive through Documo’s secure cloud fax platform. Every document is captured digitally with full metadata and is ready for processing. For multi-site organizations sending referrals by fax, every referral is routed by fax number and placed in the respective workspace.

Classify: the IDP layer organizes everything in the queue and separates referrals from prior authorizations and other documents. When the intake team opens the workspace, they only see referrals—saving valuable time and effort. 

Extract: the structured data that drives scheduling and intake decisions is pulled out. Then, the specific fields such as patient demographics, insurance information, referral provider information, and more, are configured to match the workflow. This process ensures that the output maps directly to what the intake team needs and how the EMA is configured, without having to rekey the information.

Route: referrals are then matched to the patient and routed to the right place based on configurable rules. Routing logic can be built on any combination of fields, fax numbers, senders, locations, payers, specialty, and extracted clinical data. 

For multi-location groups that have their own individual fax numbers, use several channels to receive referrals, and have multiple queues, a workspace capability allows operational leaders to have a centralized way to manage referrals. Routing is performed by fax numbers. When a referral is sent to the dermatology line, for example, the referral is pulled into the dedicated dermatology workspace. Specific members can be added to workspaces as well.

Handle exceptions: referrals that have incomplete fields, low-quality scans, or missing information are surfaced to Documo’s workspace for a human to review. Instead of spending time inspecting every document from scratch, staff save time by working a structured review queue. 

Before Documo	After Documo
Staff manually identify the document type and separate the referrals.	When documents are received, they are automatically classified.
Staff spend time reading referrals and entering patient demographics, insurance info, referring provider information, and clinical data.	Data is automatically extracted into structured fields.
Staff have to sift through a pile of referrals and other documents and route them to the right department. Fax referrals may show up near the EMA fax queue, but the rest are put into a shared inbox or a folder where they often sit.	Rules-based logic allows for routing to workspaces within seconds.
Staff spend time inspecting every document for incomplete fields, low-quality scans, or missing information.	Staff work a structured review queue that surfaces only the referrals that have to be worked.
Staff waste time tracking document status through email threads, sticky notes, and personal memory.	Every document has a complete, real-time audit trail.

Track and audit: every referral has a complete audit trail that details and verifies every step in the process. Operations leaders have real-time visibility into the queue depth, average processing time, and bottlenecks.

What Changes With Referrals With the Documo-ModMed Integration

With Documo, ModMed users process documents automatically, route them accurately, and keep workflows running smoothly—without ever having to leave the platform. With the integration, staff are freed up to spend more time on patient-facing activities. In fact, approximately 89% of early users report a 25% or greater reduction in time spent processing inbound faxes. 

Want to learn more about how to automate incoming referrals into ModMed? Explore our automated referral management solution today. 

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