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Sharing Referrals/Authorizations with Healthcare Providers


The Referrals/Authorizations screen allows healthcare providers to enter requests for referrals to other healthcare professionals and to authorize treatments, and it allows the insurance carrier to respond to these requests.

The provider enters the request in the Healthcare Provider Portal by navigating to the Referrals/Authorizations screen, creating a new request, and entering information about it. When a new request is created, it has the status of Open.

The insurance carrier can act on the request by using the Siebel Partner Manager or Siebel eHealthcare to change the Substatus to Approved, Declined or some other substatus (such as Additional Documents Required or Supervisor Approval).

The provider can see whether the request has been approved by looking at the value of the Substatus field.

For more information about the Referrals/Authorization screen, see Siebel eHealthcare Guide.

To approve or decline a referral request or authorization request

  1. Navigate to the Referrals/Authorizations screen.
  2. In the Referrals/Authorizations list, select the referral request or authorization request that you want to act on.
  3. Click the view tabs to display more information about the referral request or authorization request, such as notes that the provider wrote or attachments that the provider associated with it.
  4. In the Substatus field, choose Approved, Declined, or some other substatus if necessary.

    The provider will be able to view the substatus in the Healthcare Provider Portal.

Siebel Partner Relationship Management Administration Guide Addendum for Industry Applications