Application Guide

Creating a Referral

Step 1: Three ways to start a referral

To create a new referral, you can enter a new patient, start with a patient already in the system, or you can select a provider to whom you wish to refer a patient.

In the "Patient Lookup:" box at the top of your screen, type 3 or more characters of the patient's first or last name and pause a fraction of a second for the system to give you suggestions of names that match. You can scroll down the list to find the right name, or you can type more letters that shrink the list down to the name you want. When you get the right name, press the "Enter" key or click your left mouse button on the name. If necessary, update the demographic information (click on the "edit info" link) and update the insurance information. Then click on "Create a Referral". This puts you in the same place as if you had just entered a new patient.

Entering a new patient

From the home page, select the "Create Referral" button. You can search for an existing patient here (it works just like the "Patient Lookup:" box works), but to add a new patient click on the "Add a New Patient" link. You must enter the patient's full name, date of birth and gender. When you press "Done", the system will look for matches or near-matches in the database. Follow the instructions carefully to choose whether to proceed with entering the new name or matching to the existing patient.

Selecting the provider first

In the menu bar, select "Providers". The bottom of the page shows providers and practices that you have referred to recently. Click on one of these to select the provider. Or use the search tabs (regular or advanced) to find the provider or practice you are planning to refer to. When you get to the Provider Details page, click "Create a Referral". This will put you in the normal flow to create a referral. The provider you have selected will be included in your referral and, as usual, you have an option to change this selection before submitting the referral.

Adding, updating and verifying insurance information

Accurate demographic and insurance data is extremely important. Without it, your referrals cannot be processed quickly and reliably. The Clarity application is designed to encourage you to be as complete and precise as possible with insurance information.

Adding new insurance

Be sure you have entered the right name, date of birth and gender for your patient. The SSN is often very helpful, but we understand some patients do not give out their SSNs. As you are creating a new referral and having chosen or entered the patient, select the "Add New" link under the insurance section
  • In the payer text box below, type the first few letters of the insurance company. Note that the name may be an acronym, e.g., "BCBS" for "Blue Cross Blue Shield". Scroll down the list to choose the appropriate insurance provider. (What if the payer isn't listed?)
  • Fill in required items. Required items are marked with an asterisk (*).
    • Filling in as much information as possible (even items that are not required) may speed-up the processing time.
    • If no insurance information is available, type in "self pay" and select the payer named self pay/private pay/no insurance.

What if the payer isn't listed?

If the payer you need is not listed, choose "Request New Payer" from the drop down list. Fill in all the information you have on this plan. The most important information is
  • The insurance provider name
  • The patient's ID
  • The phone number listed on the card for provider support
Clarity will verify the insurance provider's details, create a new entry, and update your patient's record with the new information.

Adding a secondary insurance

  • In order to add secondary insurance, finish the first one and click "Add New" again and add the secondary info (make sure afterwards that the primary and secondary designations are accurate)
  • Click "Next" in the bottom-right corner of the page

Updating (or removing) insurance information for a patient

When any insurance information changes for a patient, please update the patient's record. This will speed processing of your referrals. To update insurance information, from the Patient Record click on the name of the insurance. This "hot" link will bring to a window that allows you to update any of the data about that particular patient's insurance plan. You can also remove this insurance from a patient's record by clicking through the "remove insurance" link in this pop-up window with the insurance details.

Verifying insurance information

After you click "Next" on the Patient Record, a window pops up asking you to verify the insurance information. Please review the information carefully, check the box, and select "Done".

Step 2: Referring provider, Reason and Priority

Step 3: Selecting a Specialist

Step 4: Attaching Records

Step 5: Submitting a Referral

Understanding Referral Status: What you need to know
Using your work lists
Messages to Clarity & other practices
Modifying, Copying, Extending and Canceling Referrals
Q&A / Troubleshooting
What makes a really good referral?
Contacting the Clarity Service Center