Referral operations for primary care & specialty practices

From any fax to a clean claim — in seven steps.

CareFlow One runs the whole referral pipeline: documents in, classified, cased, checked, authorized, scheduled, billing-ready. Watch one case travel it — or click any step to jump there.

AI ASSISTS · YOUR STAFF DECIDE · EVERY ACTION LOGGED

FAX · 6 PGS
PDF
EHR EXPORT
ALL OF IT → SMART INBOX
Smart Inbox
Referral — Cardiology6 PAGES · FAX→ ROUTEDREFERRAL + PA
Insurance cardPDF · FRONT/BACK→ ROUTEDCOVERAGE
Clinical noteEHR EXPORT→ ROUTEDATTACHED TO CASE
CASE C-2041 · CARDIOLOGY CONSULT
M. Alvarez — Medicare Advantage
REFERRAL ORDERDX: I48.91EKG PG 4–5
Readiness check
Insurance verified — UHC MA
EKG attached — pages 4–5
PCP notes missing — flagged before scheduling
RECORDS REQUEST SENT — AUTOMATICALLY
Prior auth — UHC Medicare Advantage
CPT 93306 requires auth — rules applied up front
Clinical criteria documented — 4 of 4
PRIOR-AUTH PACKETREADY
PACKET COMPLETE — SUBMITTED TO PAYER
Scheduling
MON
TUE2:40 PM
WED
THU9:10 AM
FRI
BOOKED — TUE 2:40 PM
Not ready yet? Each case shows its clear next step instead.
Billing readiness
Auth A-83921 attached to the visit
CPT 93306 matches the order
Documentation complete — confirmed pre-claim
CLAIM-READY
1 · FAX / PDF / EHRDocuments arrive from any source, in any format. 2 · SMART INBOXEach item is read, classified, and routed automatically. 3 · CASE CREATEDPages become a structured case with patient and order details. 4 · READINESS CHECKMissing documents and gaps are flagged before anyone schedules. 5 · PRIOR AUTHPayer requirements and packet readiness, surfaced up front. 6 · SCHEDULINGReady patients move to booking; the rest get a clear next step. 7 · BILLING READYAuth and documentation confirmed before the claim goes out.
STEP 1 / 7
The problem

Referrals arrive as paper. Your team turns them into work — by hand.

Every fax kicks off the same scramble: read it, chase what's missing, check the payer, and hope nothing slips before the visit.

Faxes pile up

Referrals sit in a queue until someone has time to read, sort, and route every page.

Missing documents delay scheduling

No PCP notes, no recent EKG, no demographics — and the patient can't be booked.

Manual payer-portal checks

Staff log into portal after portal to confirm eligibility and authorization rules.

Prior-auth rules are hard to track

Requirements vary by payer, plan, and CPT — and they change without warning.

Patients wait

While teams chase information, appointments slip and referring offices call to ask why.

Billing risk grows quietly

Incomplete authorization or documentation surfaces as denials — weeks after the visit.

The seven steps

Each step removes a job your team does by hand.

The same pipeline you watched above — and the manual work that disappears at each stop.

THE STEPWHAT STOPS HAPPENING
1

Fax / PDF / EHR

Documents arrive from any source, in any format.

No more watching three inboxes and a fax machine.
2

Smart Inbox

Each item is read, classified, and routed automatically.

No more reading and sorting every page by hand.
3

Case Created

Pages become a structured case with patient and order details.

No more re-keying demographics and order details.
4

Readiness Check

Missing documents and gaps are flagged before anyone schedules.

No more discovering missing notes at check-in.
5

Prior Auth

Payer requirements and packet readiness, surfaced up front.

No more portal-by-portal rule hunting.
6

Scheduling

Ready patients move to booking; the rest get a clear next step.

No more guessing who's actually bookable.
7

Billing Ready

Auth and documentation confirmed before the claim goes out.

No more denials surfacing weeks after the visit.
Who it's for

One platform. Both sides of the referral.

CareFlow One serves the practice that sends the referral and the practice that receives it — so the same case stays complete, authorized, and visible on both ends.

SENDS · PRIMARY CARE

CareFlow One for Primary Care

Refer, verify coverage, and submit e-PAs before the patient leaves the room.

  • Coverage and network verified before you submit — not after the callback.
  • Packets leave complete — documents, codes, and prior-auth rules applied up front.
  • Every case tracked to the finish — no portals, no "any update?" calls.
RECEIVES · SPECIALTY CARE

CareFlow One for Specialty Care

Turn inbound faxes into ready-to-work cases with readiness checks, prior auth, and next actions.

  • Faxes become structured cases automatically — no re-keying, no sorting.
  • Gaps and prior-auth risk flagged day one — not discovered at check-in.
  • Billing confirmed clean pre-claim — denials prevented, not discovered weeks later.
Trust & control

AI that assists. Staff who decide.

Human review before final action

Recommendations stay recommendations until a team member approves them.

Audit trail for AI-assisted decisions

Every classification, flag, and action is logged and reviewable.

HIPAA-conscious workflows

Designed around minimum-necessary access and careful PHI handling.

Role-based access

Front desk, prior-auth, and billing each see what their work requires.

Secure document handling

Inbound faxes and PDFs are stored and transmitted with care.

Staff remain in control

CareFlow One queues and suggests. People schedule, submit, and bill.

CareFlow One is designed to support careful, compliant operations. Ask about current security and privacy practices during your demo.

See your own faxes make the trip.

A 30-minute demo with your referral volume, payers, and document mix — all seven steps, live.